Licker M, Diaper J, Robert J, Ellenberger C
Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva, CH-1211 Geneva, Switzerland.
Anaesthesia. 2008 Apr;63(4):352-7. doi: 10.1111/j.1365-2044.2007.05354.x.
Delayed emergence from anaesthesia and neurological disturbances have been reported in patients undergoing parathyroidectomy who received methylene blue (MB) pre-operatively. We hypothesised that MB would decrease propofol requirements. The Bispectral index (BIS) and a target-controlled infusion of propofol were used in two groups of 11 matched patients. Patients in one group were pretreated with MB. During induction, clinical sedation scores and BIS values were significantly lower at the predicted effect-site propofol concentration of 2 microg x ml(-1) in the MB compared with the control group. Intra-operatively, although similar BIS values were achieved in the two groups, patients pretreated with MB required a mean 50% lower dose of propofol compared with controls. In view of these findings, care should be taken to ensure an adequate depth of anaesthesia by titrating the administration of anaesthetic agents whenever MB is infused peri-operatively.
据报道，术前接受亚甲蓝（MB）治疗的甲状旁腺切除术患者出现麻醉苏醒延迟和神经功能障碍。我们假设MB会降低丙泊酚的需求量。两组各11例匹配患者使用脑电双频指数（BIS）和丙泊酚靶控输注。一组患者术前接受MB预处理。诱导期间，与对照组相比，在MB组中，当预测效应室丙泊酚浓度为2μg·ml⁻¹时，临床镇静评分和BIS值显著更低。术中，尽管两组的BIS值相似，但与对照组相比，接受MB预处理的患者丙泊酚平均剂量低50%。鉴于这些发现，在围手术期输注MB时，应注意通过滴定麻醉药物的给药来确保足够的麻醉深度。
