Igarashi Tae, Nagata Osamu, Kuroyanagi Aya, Iwakiri Hiroko, Ozaki Makoto
Department of Anesthesia, Saiseikai Kawaguchi General Hospital, Kawaguchi 332-8558
Masui. 2009 Nov;58(11):1407-12.
Propofol target-controlled infusion (TCI) is now commonly used for the induction and maintenance of anesthesia. In this study, we measured the propofol plasma concentrations of elderly patients to evaluate our hypothesis that propofol TCI is reliable for use in elderly patients.
We measured plasma concentrations of propofol in 10 elderly patients undergoing elective general anesthesia. Propofol TCI was commenced at a target plasma concentration of 3 microg x ml(-1) using a TCI pump. The target concentration was kept at 3 microg x ml(-1) for 2-3 hours. Arterial blood samples were drawn for measurement of the propofol plasma-concentration analysis at 30, 60, 90, 120 and 180 minutes after the induction of anesthesia, and at the emergence from anesthesia.
The measured plasma concentrations of propofol were not significantly different from the target plasma concentrations. The mean estimated and measured plasma concentrations at emergence were at about 1 microg x ml(-1), respectively.
We concluded that propofol TCI is a reliable method for maintaining anesthesia even in elderly patients, whereas the individual differences of the elderly patients was greater than those obtained from normal patients.
丙泊酚靶控输注(TCI)目前常用于麻醉诱导和维持。在本研究中,我们测量了老年患者的丙泊酚血浆浓度,以评估我们的假设,即丙泊酚TCI用于老年患者是可靠的。
我们测量了10例接受择期全身麻醉的老年患者的丙泊酚血浆浓度。使用TCI泵以3μg·ml⁻¹的目标血浆浓度开始丙泊酚TCI。目标浓度保持在3μg·ml⁻¹ 2 - 3小时。在麻醉诱导后30、60、90、120和180分钟以及麻醉苏醒时采集动脉血样,用于丙泊酚血浆浓度分析测量。
测得的丙泊酚血浆浓度与目标血浆浓度无显著差异。苏醒时估计和测得的血浆平均浓度分别约为1μg·ml⁻¹。
我们得出结论,丙泊酚TCI即使在老年患者中也是维持麻醉的可靠方法,而老年患者的个体差异大于正常患者。