Irwin M G, Thompson N, Kenny G N
Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Anaesthesia. 1997 Jun;52(6):525-30. doi: 10.1111/j.1365-2222.1997.123-az0117.x.
We have developed a system which allows patients to operate a target-controlled infusion of propofol to provide sedation and we have studied its use in 36 unpremedicated patients undergoing local and regional anaesthetic procedures lasting 10-280 min. An intravenous propofol infusion was started at a target plasma level of 1 microgram.ml-1. The patient was able to increase the target propofol concentration in 0.2- microgram.ml-1 increments by pressing a demand button. There was a lockout interval of 2 min and a maximum permissible target concentration of 3 micrograms.ml-1. There was considerable interindividual variability in propofol consumption (mean 39.3 micrograms.kg-1.min-1, range 3-131 micrograms.kg-1.min-1), no cardiovascular instability and little oversedation. Eight patients required supplementary oxygen. Optimal sedation was provided at median target concentrations of 0.8-0.9 microgram.ml-1. The target-controlled infusion system bias was-47% and the inaccuracy was 48%. Patient satisfaction was high and 89% said that they would definitely use the technique again. This technique combines the benefits of target-controlled infusion with patient-controlled feedback and produces safe intra-operative sedation.
我们开发了一种系统，该系统可让患者自行控制丙泊酚的靶控输注以提供镇静作用，并且我们已对36例未使用术前药、接受持续10 - 280分钟局部和区域麻醉手术的患者使用该系统的情况进行了研究。静脉输注丙泊酚，起始靶血浆浓度为1微克·毫升⁻¹。患者可通过按下需求按钮以0.2微克·毫升⁻¹的增量增加丙泊酚靶浓度。锁定间隔为2分钟，最大允许靶浓度为3微克·毫升⁻¹。丙泊酚的消耗量存在相当大的个体差异（平均39.3微克·千克⁻¹·分钟⁻¹，范围3 - 131微克·千克⁻¹·分钟⁻¹），未出现心血管不稳定情况，且过度镇静现象较少。8例患者需要补充氧气。在靶浓度中位数为0.8 - 0.9微克·毫升⁻¹时可提供最佳镇静效果。靶控输注系统的偏倚为 - 47%，不准确度为48%。患者满意度较高，89%的患者表示肯定会再次使用该技术。该技术将靶控输注的优点与患者自控反馈相结合，可产生安全的术中镇静效果。
