Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People's Republic of China.
Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210000, People's Republic of China.
Clin Interv Aging. 2023 Feb 28;18:307-315. doi: 10.2147/CIA.S380416. eCollection 2023.
This study aimed to compare the half-effective concentration (EC50) of propofol required for the bispectral index (BIS) 50 in patients with Parkinson's disease (PD) and non-PD (NPD) during induction by the Dixon's improved sequential method.
This prospective study recruited 20 patients with PD undergoing deep brain stimulation and 20 patients with NPD accompanied by meningioma or glioma undergoing intracranial surgery from March 2018 to March 2019. The patients were induced by propofol via target-controlled infusion. The target effect-site concentration of propofol was determined by the Dixon's improved sequential method. The results of the pilot experiment showed that the target effect-site concentration for the first patient with PD and NPD was 3.5 µg/mL and 2.8 µg/mL, respectively. BIS values were recorded after achieving a constant effect-site concentration of propofol. The increment or decrement of the target effect-site concentration of the next patient was 0.1 µg/mL.
Demographic data, general physical condition, and hemodynamic values were similar between the PD and the NPD groups. The target effect-site concentration of propofol induction doses was significantly higher in the PD group than in the NPD group. The EC50 of propofol required for BIS 50 was 3.213 µg/mL [95% confidence interval (CI), 3.085-3.287 µg/mL] in the PD group and 2.77 µg/mL (95% CI, 2.568-2.977 µg/mL) in the NPD group.
The EC50 of propofol required for BIS 50 was higher in patients with PD than in patients with NPD.
本研究旨在通过 Dixon 改良序贯法比较帕金森病（PD）患者和非帕金森病（NPD）患者在脑深部刺激术和颅内手术时，脑电双频指数（BIS）为 50 时所需的异丙酚半数有效浓度（EC50）。
本前瞻性研究纳入了 2018 年 3 月至 2019 年 3 月期间行脑深部刺激术的 20 例 PD 患者和 20 例伴有脑膜瘤或胶质瘤行颅内手术的 NPD 患者。患者通过靶控输注异丙酚诱导麻醉，采用 Dixon 改良序贯法确定异丙酚效应室靶浓度。预实验结果显示，首位 PD 患者和 NPD 患者的异丙酚效应室靶浓度分别为 3.5µg/ml 和 2.8µg/ml。达到异丙酚效应室靶浓度稳定后记录 BIS 值。下一位患者的效应室靶浓度增减量为 0.1µg/ml。
PD 组和 NPD 组患者的一般资料、一般身体状况和血流动力学值无显著差异。PD 组异丙酚诱导剂量的效应室靶浓度显著高于 NPD 组。PD 组患者 BIS 为 50 时所需的异丙酚 EC50 为 3.213µg/ml（95%CI，3.085-3.287µg/ml），NPD 组为 2.77µg/ml（95%CI，2.568-2.977µg/ml）。
与 NPD 患者相比，PD 患者 BIS 为 50 时所需的异丙酚 EC50 更高。
