Department of Anesthesiology, School of Medicine, Pamukkale University, Denizli, Turkey.
Eur Rev Med Pharmacol Sci. 2013 Dec;17(24):3385-90.
To investigate biochemically whether total intravenous anesthesia (TIVA) using propofol creates a risk for Propofol Infusion Syndrome (PRIS).
Forty patients scheduled for thyroid gland surgery were randomly assigned into Group T or C and premedicated 30 min before operation. Group T received remifentanyl hydrochloride, propofol infusion following anesthesia induction with propofol, vecuronium bromide and intubation. Group C received remifentanyl hydrochloride infusion, 1-1.5 MAC desflurane inhalation following anesthesia induction with thiopental, vecuronium bromide and intubation. Patients were respired 50% O2-air mixture. Blood gas, potassium, lactic acid, CK-MB, myoglobin, troponin I, total carnitine, triglyceride, creatinine concentrations were determined before operation, at intraoperative hour-2, postoperative hour-6.
There were no significant differences between groups in potassium, lactic acid CK-MB, myoglobin, total carnitine or creatinine levels. Triglyceride level at intraoperative hour-2 increased in Group T, decreased at postoperative hour-6. Troponin I was higher in Group C than Group T at intraoperative hour-2 (p < 0.05). No asystole, bradycardia, arrhythmia, hypotension or change in urine color was detected.
The present biochemical findings suggest that TIVA using propofol is safe.
研究全凭静脉麻醉(TIVA)使用丙泊酚是否会增加丙泊酚输注综合征(PRIS)的风险。
40 名计划行甲状腺手术的患者被随机分为 T 组或 C 组,并在手术前 30 分钟进行预给药。T 组在麻醉诱导时给予丙泊酚、瑞芬太尼盐酸盐、维库溴铵和插管,随后给予丙泊酚输注。C 组在麻醉诱导时给予硫喷妥钠、瑞芬太尼盐酸盐、维库溴铵和插管,随后给予 1-1.5 MAC 地氟烷吸入。患者均以 50%氧气-空气混合物呼吸。在术前、术中第 2 小时、术后第 6 小时测定血气、钾、乳酸、肌酸激酶同工酶(CK-MB)、肌红蛋白、肌钙蛋白 I、总肉碱、甘油三酯、肌酐浓度。
两组间钾、乳酸、CK-MB、肌红蛋白、总肉碱或肌酐水平无显著差异。T 组术中第 2 小时甘油三酯水平升高,术后第 6 小时降低。C 组术中第 2 小时肌钙蛋白 I 高于 T 组(p<0.05)。未发生心动过缓、心律失常、低血压或尿液颜色改变。
目前的生化结果表明,TIVA 使用丙泊酚是安全的。