Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan, China.
J Dig Dis. 2013 Mar;14(3):147-52. doi: 10.1111/1751-2980.12020.
Target-controlled infusion (TCI) of propofol is an effective way of delivering propofol during endoscopy. However, the ideal effect-site concentration (Ce) of propofol has not yet been defined in an Asian population. This study aimed to determine the ideal Ce of propofol in painless gastrointestinal endoscopy in a Taiwanese population.
A total of 121 consecutive patients undergoing diagnostic endoscopy were recruited for this study. The endoscopic procedure was carried out within 1 h. TCI of propofol was utilized during the procedure. All patients received the same regimen to induce conscious sedation, including a bolus of midazolam (0.04 mg/kg) and fentanyl (0.5 μg/kg). The Ce of propofol was calculated using the Schneider model. Patients were randomly assigned to either the low Ce group (1.5-2.5 μg/mL) or high Ce group (3.0-4.0 μg/mL). Their cardiovascular and respiratory events were monitored during the procedure and the patients' post-procedure satisfaction was evaluated.
The mean requirement for propofol was 232.02 mg in the low Ce group and 329.56 mg in the high Ce group, respectively (P < 0.0001). No unexpected event was observed in either group. However, more episodes of hypotension were observed in the high Ce group (P = 0.026). The post-procedure satisfaction rate between the two groups was comparable.
A low Ce of propofol TCI (1.5-2.5 μg/mL) achieved adequate anesthesia, reduced the risk of hypotension, and attained a high satisfaction rate in a Taiwanese population undergoing diagnostic painless endoscopy.
靶控输注（TCI）丙泊酚是在进行内镜检查时给予丙泊酚的一种有效方法。然而，在亚洲人群中，丙泊酚的理想效应部位浓度（Ce）尚未确定。本研究旨在确定台湾人群在无痛胃肠内镜检查中丙泊酚的理想 Ce。
本研究共纳入 121 例连续接受诊断性内镜检查的患者。内镜检查在 1 小时内进行。该过程中使用 TCI 给予丙泊酚。所有患者均接受相同的方案以诱导清醒镇静，包括咪达唑仑（0.04 mg/kg）和芬太尼（0.5 μg/kg）的负荷剂量。丙泊酚的 Ce 使用 Schneider 模型计算。患者随机分为低 Ce 组（1.5-2.5 μg/mL）或高 Ce 组（3.0-4.0 μg/mL）。监测他们在手术过程中的心血管和呼吸事件，并评估患者术后满意度。
低 Ce 组丙泊酚的平均需求量为 232.02 mg，高 Ce 组为 329.56 mg（P<0.0001）。两组均未观察到意外事件。然而，高 Ce 组观察到更多的低血压发作（P=0.026）。两组的术后满意度相当。
在进行诊断性无痛内镜检查的台湾人群中，低 Ce （1.5-2.5 μg/mL）的丙泊酚 TCI 可实现充分的麻醉，降低低血压的风险，并获得较高的满意度。
