Takeshita M, Karaba T, Tanaka N, Kondou O, Watanabe Y, Takasaki M
Department of Anesthesiology, Miyazaki Medical College.
Masui. 1998 Sep;47(9):1099-103.
The sedative and hypnotic properties of propofol were studied in 40 patients undergoing elective gynecologic or orthopedic surgery using epidural (epidural group, n = 20) or spinal (spinal group, n = 20) anesthesia. Patients were given a bolus dose of 1 mg.kg-1 immediately followed by a continuous infusion of 4 mg.kg-1.h-1 of propofol after epidural or spinal anesthesia. The patients were asked to open their eyes on command at 10-sec interval from the end of the bolus infusion of propofol. We administered oxygen when SpO2 decreased below 93%. The mean induction time to reach the level of sedation, no response to verbal command to open their eyes, was 6 +/- 10 (SD) min in the epidural group, and 7 +/- 17 min in the spinal group. The mean recovery times, judged by ability to open eyes and recall date of birth, were 4 +/- 4 min and 7 +/- 6 min in the epidural group, and 4 +/- 4 min and 5 +/- 5 min in the spinal group, respectively. There were no differences in all recorded times between the two groups. Oxygen inhalation was needed in 75% of the patients in the epidural group and 100% in the spinal group. These results indicate that bolus and continuous infusion of propofol produces rapid induction, deep level of sedation, and rapid recovery during epidural or spinal anesthesia. However, respiratory depression appeared at this infusion rate during regional anesthesia.
在40例接受择期妇科或骨科手术的患者中，使用硬膜外麻醉（硬膜外组，n = 20）或脊髓麻醉（脊髓组，n = 20）研究了丙泊酚的镇静和催眠特性。患者在硬膜外或脊髓麻醉后立即给予1 mg·kg-1的推注剂量，随后以4 mg·kg-1·h-1的速度持续输注丙泊酚。从丙泊酚推注输注结束开始，要求患者每隔10秒按指令睁开眼睛。当SpO2降至93%以下时，我们给予氧气。硬膜外组达到镇静水平（对睁眼的言语指令无反应）的平均诱导时间为6±10（标准差）分钟，脊髓组为7±17分钟。根据睁眼能力和回忆出生日期判断，硬膜外组的平均恢复时间分别为4±4分钟和7±6分钟，脊髓组分别为4±4分钟和5±5分钟。两组之间所有记录时间均无差异。硬膜外组75%的患者和脊髓组100%的患者需要吸氧。这些结果表明，丙泊酚的推注和持续输注在硬膜外或脊髓麻醉期间可产生快速诱导、深度镇静和快速恢复。然而，在区域麻醉期间，以该输注速率出现了呼吸抑制。
