Dundee J W, Robinson F P, McCollum J S, Patterson C C
Anaesthesia. 1986 May;41(5):482-5. doi: 10.1111/j.1365-2044.1986.tb13271.x.
Two studies were carried out on 609 fit, unpremedicated patients to assess the influence of patient age on the response to the rapidly-acting hindered phenol, propofol, which is being evaluated for induction of anaesthesia. In the first study, 1.25 mg/kg was injected over 20 seconds followed by 10-mg increments every 15 seconds until loss of verbal contact. This showed a great individual variation in response to the drug. A reduction in the 'induction' dose was found in elderly patients, which became marked around 60 years. In the second (340), doses ranging from 1.5-3.0 mg/kg in patients under 60 years and 1.25-2.25 mg/kg in those over 60 years were injected as a bolus over 20 seconds. Doses of 2.25-2.5 mg/kg were required to induce anaesthesia in patients under 60 years, whilst 1.5-1.75 mg/kg was adequate in those over 60 years. Side effects were more marked with the rapid injection and doses in excess of 1.75 mg/kg caused significant hypotension and apnoea in the elderly. These studies reveal marked sensitivity to propofol in the elderly with respect to both induction dose and acute toxicity.
针对609名健康且未使用术前药的患者开展了两项研究，以评估患者年龄对快速起效的受阻酚类药物丙泊酚反应的影响，丙泊酚正被用于麻醉诱导的评估。在第一项研究中，在20秒内注射1.25毫克/千克，随后每15秒增加10毫克，直至患者失去语言应答。这显示出个体对该药物的反应存在很大差异。研究发现老年患者的“诱导”剂量降低，在60岁左右这种降低变得明显。在第二项研究中，60岁以下患者以20秒静脉推注1.5 - 3.0毫克/千克，60岁以上患者为1.25 - 2.25毫克/千克。60岁以下患者诱导麻醉需要2.25 - 2.5毫克/千克的剂量，而60岁以上患者1.5 - 1.75毫克/千克就足够。快速注射时副作用更明显，超过1.75毫克/千克的剂量会导致老年患者出现显著的低血压和呼吸暂停。这些研究表明老年人对丙泊酚在诱导剂量和急性毒性方面都表现出明显的敏感性。
