Oei-Lim V L, Kalkman C J, Makkes P C, Ooms W G, Hoogstraten J
Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, The Netherlands.
Br Dent J. 1997 Sep 27;183(6):204-8. doi: 10.1038/sj.bdj.4809467.
To assess a drug delivery system that can rapidly achieve and maintain a constant blood concentration of Propofol (2,6 di-isopropyl phenol) which, in subanaesthetic doses, is an effective intravenous sedative for treating anxious or handicapped patients in dentistry.
The clinical use of a computer controlled infusion system to induce and maintain conscious sedation with propofol was prospectively studied. Based on a 3-compartment pharmacokinetic model, the system calculates the initial bolus dose and infusion rates to achieve a user-selected target blood concentration.
Amsterdam Center for Special Dental Care.
89 patients attending for dental treatment.
Treatment could be performed within 2 minutes after the onset of the infusion. The median therapeutic target blood propofol concentration was 2.5 micrograms/ml and the median recovery time was 9 minutes. Transient oversedation (38 procedures) could easily be treated by decreasing the target concentration. No adverse cardiorespiratory effects resulted from propofol sedation. Venous blood propofol concentrations were measured in 25 anxious patients. The kinetic data set used in this study underestimated the distribution and elimination of propofol in our patients.
Computer controlled infusion of propofol can provide satisfactory and safe conscious sedation in dental patients.
评估一种药物输送系统，该系统能够快速达到并维持丙泊酚（2,6 - 二异丙基苯酚）的恒定血药浓度，丙泊酚在亚麻醉剂量下是一种有效的静脉镇静剂，可用于治疗牙科焦虑或残疾患者。
前瞻性研究使用计算机控制输注系统以丙泊酚诱导和维持清醒镇静的临床应用。基于三室药代动力学模型，该系统计算初始推注剂量和输注速率，以达到用户选择的目标血药浓度。
阿姆斯特丹特殊牙科护理中心。
89名接受牙科治疗的患者。
输注开始后2分钟内即可进行治疗。丙泊酚治疗的目标血药浓度中位数为2.5微克/毫升，恢复时间中位数为9分钟。短暂性过度镇静（38例）可通过降低目标浓度轻松处理。丙泊酚镇静未产生不良心肺效应。对25名焦虑患者测量了静脉血丙泊酚浓度。本研究中使用的动力学数据集低估了丙泊酚在我们患者中的分布和消除情况。
计算机控制输注丙泊酚可为牙科患者提供满意且安全的清醒镇静。
