Schaer H
Anaesthesie-Abteilung, Kreisspital Männedorf.
Anaesthesist. 1988 Mar;37(3):187-92.
The administration of propofol by infusion for maintenance of anesthesia has attracted much attention recently. We investigated the necessary infusion rate of propofol to maintain anesthesia for short surgical procedures without loss of the evident advantages of this substance. Forty unpremedicated female patients aged 18-59, scheduled for minor gynecological procedures, were randomly assigned to four groups. Anesthesia was induced with 2.0 mg/kg propofol i.v. and simultaneously an infusion of 0.05, 0.10, 0.15, or 0.20 mg propofol/kg per minute was started. The patients were breathing N2O/O2 with FIO2 33%. Additional propofol was administered as a bolus of 10 to 20 mg when the patients moved. With 0.05 mg propofol/kg per minute all patients required additional bolus injections of propofol; with 0.10 mg 8 patients, with 0.15 mg 5 patients, and with 0.20 mg 1 patient required bolus injection. Therefore, 0.15 mg/kg per minute can be considered as an approximate ED50 value. The total propofol consumption (infusion + bolus) increased from 0.102 +/- 0.028 (+/- SD) with the lowest infusion rate to 0.202 +/- 0.006 mg/kg per minute with the highest infusion rate and recovery time from 5.2 +/- 1.4 to 9.9 +/- 2.6 min. There was a significant correlation between propofol consumption and recovery time. After induction, arterial blood pressure decreased by systolic/diastolic 20/10-15 mmHg. With the low infusion rate, arterial pressure increased to its control value during operation; it remained at the postinduction value with high infusion rates. Side-effects: 10 patients had salivation that in some instances lead to coughing, 9 reported pain at the injection site during induction, and 9 reported dreams of a pleasant nature.(ABSTRACT TRUNCATED AT 250 WORDS)
通过输注丙泊酚维持麻醉近来备受关注。我们研究了在短时间外科手术中维持麻醉所需的丙泊酚输注速率,同时不丧失该药物的明显优势。40例年龄在18至59岁、未接受术前用药、计划进行小型妇科手术的女性患者被随机分为四组。静脉注射2.0mg/kg丙泊酚诱导麻醉,同时分别开始以每分钟0.05、0.10、0.15或0.20mg丙泊酚/kg的速率进行输注。患者吸入含33%氧的氧化亚氮/氧气混合气。患者出现活动时,给予10至20mg丙泊酚推注。以每分钟0.05mg丙泊酚/kg的速率输注时,所有患者均需额外推注丙泊酚;以每分钟0.10mg的速率输注时,8例患者需要推注;以每分钟0.15mg的速率输注时,5例患者需要推注;以每分钟0.20mg的速率输注时,1例患者需要推注。因此,每分钟0.15mg/kg可被视为近似的半数有效剂量(ED50)值。丙泊酚总消耗量(输注量+推注量)从最低输注速率时的0.102±0.028(±标准差)mg/kg每分钟增加到最高输注速率时的0.202±0.006mg/kg每分钟,恢复时间从5.2±1.4分钟延长至9.9±2.6分钟。丙泊酚消耗量与恢复时间之间存在显著相关性。诱导后,动脉血压收缩压/舒张压下降20/10至15mmHg。低输注速率时,术中动脉压升至对照值;高输注速率时,动脉压维持在诱导后的值。副作用:10例患者出现流涎,部分病例导致咳嗽,9例患者报告诱导期间注射部位疼痛,9例患者报告有愉悦性质的梦境。(摘要截断于250字)