Alvis J M, Reves J G, Govier A V, Menkhaus P G, Henling C E, Spain J A, Bradley E
Anesthesiology. 1985 Jul;63(1):41-9. doi: 10.1097/00000542-198507000-00006.
The design and implementation of a computer-assisted continuous infusion (CACI) system to rapidly attain and maintain a constant plasma fentanyl concentration (PFC), as well as a CACI system that allowed the anesthesiologist to change the plasma level of fentanyl during cardiac anesthesia, were developed. In 30 patients (three groups of 10 patients each) these two automated methods of fentanyl infusion were compared with a manual fentanyl administration method. There was excellent agreement in the measured/predicted PFC ratios with the CACI stable fentanyl level system (ratio = 0.99, n = 91) and in the CACI variable fentanyl level system (ratio = 1.08, n = 79). The stable fentanyl level group of patients received significantly more (P less than 0.05) fentanyl than did the other groups. The CACI variable fentanyl level group of patients had greater hemodynamic stability, required significantly (P less than 0.05) fewer adjuvant drug interventions and experienced significantly (P less than 0.05) fewer hypotensive and hypertensive episodes than the manual, bolus fentanyl (control) group. These data show that a computer-assisted automated infusion of fentanyl is safe and as good as manual methods. CACI has greater potential as a new method of intravenous anesthesia administration.
开发了一种计算机辅助持续输注（CACI）系统，用于快速达到并维持恒定的血浆芬太尼浓度（PFC），以及一种允许麻醉医生在心脏麻醉期间改变芬太尼血浆水平的CACI系统。在30例患者（每组10例，共三组）中，将这两种自动化芬太尼输注方法与手动芬太尼给药方法进行了比较。在CACI稳定芬太尼水平系统中，测量/预测的PFC比值具有极佳的一致性（比值 = 0.99，n = 91），在CACI可变芬太尼水平系统中也是如此（比值 = 1.08，n = 79）。稳定芬太尼水平组患者接受的芬太尼显著多于其他组（P < 0.05）。与手动推注芬太尼（对照）组相比，CACI可变芬太尼水平组患者具有更好的血流动力学稳定性，辅助药物干预显著减少（P < 0.05），低血压和高血压发作也显著减少（P < 0.05）。这些数据表明，计算机辅助自动输注芬太尼是安全的，且与手动方法效果相当。CACI作为一种新的静脉麻醉给药方法具有更大的潜力。
