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全凭静脉麻醉下硬质支气管镜检查中丙泊酚和瑞芬太尼输注模式的分析

Analysis of Infusion Patterns of Propofol and Remifentanil During Rigid Bronchoscopy Under Total Intravenous Anesthesia.

作者信息

Park Jong Cook, Yun So Hui, Kim Changhwan

机构信息

Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.

Division of Pulmonary, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.

出版信息

Anesth Pain Med. 2020 Sep 7;10(4):e102983. doi: 10.5812/aapm.102983. eCollection 2020 Aug.

Abstract

OBJECTIVES

We analyzed the dosage pattern of anesthetic drugs administered to maintain anesthesia during rigid bronchoscopy.

METHODS

We enrolled a total of 81 patients who underwent rigid bronchoscopy under total intravenous anesthesia between April 2015 and March 2019. Anesthesia was maintained using propofol (target brain concentration 2.0 - 6.0 µg/mL) and remifentanil (target brain concentration 2.0 - 6.0 ng/mL). We analyzed the dosage patterns of the anesthetic agents during the procedure, as well as the changes in the dose of the anesthetic agents and the number of procedures repeated in the same patient.

RESULTS

The dose of propofol administered per minute to maintain anesthesia was inversely correlated with the total operation time (r = 0.355, β = -0.067, P < 0.000) but was not significantly correlated with the number of times the procedure was repeated. The dose of remifentanil did not significantly differ during repeated procedures in the same patient.

CONCLUSIONS

The dose of propofol infusion tended to decrease over time during the rigid bronchoscopy procedure. This pattern was specific to propofol but not to remifentanil using TIVA. Understanding the pharmacokinetic properties of anesthetic drugs will help in their appropriate administration.

摘要

目的

我们分析了在硬质支气管镜检查期间用于维持麻醉的麻醉药物的给药模式。

方法

我们纳入了2015年4月至2019年3月期间在全静脉麻醉下接受硬质支气管镜检查的81例患者。使用丙泊酚(目标脑浓度2.0 - 6.0µg/mL)和瑞芬太尼(目标脑浓度2.0 - 6.0 ng/mL)维持麻醉。我们分析了手术过程中麻醉剂的给药模式,以及麻醉剂剂量的变化和同一患者重复手术的次数。

结果

维持麻醉时每分钟丙泊酚的给药剂量与总手术时间呈负相关(r = 0.355,β = -0.067,P < 0.000),但与手术重复次数无显著相关性。同一患者重复手术期间瑞芬太尼的剂量无显著差异。

结论

在硬质支气管镜检查过程中,丙泊酚输注剂量随时间有下降趋势。这种模式是丙泊酚特有的,而使用全静脉麻醉时瑞芬太尼并非如此。了解麻醉药物的药代动力学特性将有助于其合理给药。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9589/7539044/526704ae0660/aapm-10-4-102983-i001.jpg

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