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犬中丙泊酚效应室靶控输注的进展:丙泊酚的效应室消除速率常数(k(e0))

A step towards effect-site target-controlled infusion with propofol in dogs: a k(e0) for propofol.

作者信息

Brás S, Bressan N, Ribeiro L, Ferreira D A, Antunes L, Nunes C S

机构信息

Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto; Hospital Geral de Santo António, Serviço de Anestesiologia, Porto, Portugal.

出版信息

J Vet Pharmacol Ther. 2009 Apr;32(2):182-8. doi: 10.1111/j.1365-2885.2008.01019.x.

Abstract

Target-controlled infusion (TCI) anesthesia using target effect-site concentration rather than plasma concentration provides less drug consumption, safer anesthesia, less undesired side effects and improved animal welfare. The aim of this study was to calculate the constant that converts propofol plasma into effect-site concentration (k(e0)) in dogs, and to implement it in a TCI system and compare it with the effect on the central nervous system (CNS). All dogs were subjected to general anesthesia using propofol. Fourteen dogs were used as the pilot group to calculate k(e0), using the t(peak) method. Fourteen dogs were used as the test group to test and validate the model. RUGLOOP II software was used to drive the propofol syringe pump and to collect data from S/5 Datex monitor and cerebral state monitor. The calculated k(e0) was incorporated in an existing pharmacokinetic model (Beths Model). The relationship between propofol effect site concentrations and anesthetic planes, and propofol plasma and effect-site concentrations was compared using Pearson's correlation analysis. Average t(peak) was 3.1 min resulting in a k(e0) of 0.7230 min(-1). The test group showed a positive correlation between anesthetic planes and propofol effect-site concentration (R = 0.69; P < 0.0001). This study proposes a k(e0) for propofol with results that demonstrated a good adequacy for the pharmacokinetic model and the measured effect. The use of this k(e0) will allow an easier propofol titration according to the anesthetic depth, which may lead to a reduction in propofol consumption and less undesired side effects usually associated to high propofol concentrations in dogs.

摘要

使用效应室浓度而非血浆浓度的靶控输注(TCI)麻醉可减少药物消耗,使麻醉更安全,减少不良副作用并改善动物福利。本研究的目的是计算犬体内将丙泊酚血浆浓度转换为效应室浓度的常数(k(e0)),并将其应用于TCI系统,同时比较其对中枢神经系统(CNS)的影响。所有犬均使用丙泊酚进行全身麻醉。14只犬作为试验组,采用t(peak)法计算k(e0)。另外14只犬作为测试组,对模型进行测试和验证。使用RUGLOOP II软件驱动丙泊酚注射泵,并从S/5 Datex监护仪和脑状态监测仪收集数据。计算得到的k(e0)被纳入现有的药代动力学模型(贝茨模型)。使用Pearson相关分析比较丙泊酚效应室浓度与麻醉平面之间以及丙泊酚血浆浓度与效应室浓度之间的关系。平均t(peak)为3.1分钟,得出k(e0)为0.7230 min(-1)。测试组显示麻醉平面与丙泊酚效应室浓度之间呈正相关(R = 0.69;P < 0.0001)。本研究提出了丙泊酚的k(e0),结果表明该常数对药代动力学模型和所测效应具有良好的适用性。使用该k(e0)将使根据麻醉深度进行丙泊酚滴定更加容易,这可能会减少丙泊酚的消耗,并减少通常与犬体内高丙泊酚浓度相关的不良副作用。

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