Kakinohana M, Tokumine J, Shimabukuro T, Taira Y, Okuda Y
Department of Anesthesiology, Faculty of Medicine, University of the Ryukyus, Okinawa.
Masui. 1998 Sep;47(9):1104-8.
Patient-controlled sedation (PCS) using propofol under spinal anesthesia in transurethral lithotripsy was carried out in a 44 year old patient with von Gierke disease accompanied with liver dysfunction, chronic renal failure, hypoglycemia and metabolic acidosis. After administering spinal anesthesia PCS was started (0.2 mg.kg-1 intravenous bolus dose of propofol; infusion at 2 mg.kg-1.h-1; a three-minute lockout time interval following an initial doses of 0.4 mg.kg-1). PCS with propofol, throughout the operation, brought about adequate sedation level for this patient with 2 or 3 on Wilson's sedation score, and the sedative effect by propofol diminished quickly within 15 minutes after the end of PCS. In addition, respiratory depression due to this sedation which would be worse in acidotic condition was not seen using PCS during the operation. This patient was much satisfied with this sedation in an interview during the postoperative period. PCS using propofol is a useful method without respiratory depression for a patient with von Gierke disease.
对一名患有冯·吉尔克病并伴有肝功能不全、慢性肾衰竭、低血糖和代谢性酸中毒的44岁患者，在经尿道碎石术的脊髓麻醉下实施了丙泊酚患者自控镇静（PCS）。给予脊髓麻醉后开始PCS（丙泊酚静脉推注剂量为0.2mg·kg-1；以2mg·kg-1·h-1的速度输注；初始剂量为0.4mg·kg-1后锁定时间间隔为3分钟）。在整个手术过程中，丙泊酚的PCS使该患者的镇静水平达到威尔逊镇静评分2或3分，且丙泊酚的镇静效果在PCS结束后15分钟内迅速消失。此外，在手术过程中使用PCS未观察到因这种镇静导致的呼吸抑制，而在酸中毒情况下呼吸抑制会更严重。该患者在术后访谈中对这种镇静非常满意。对于患有冯·吉尔克病的患者，使用丙泊酚的PCS是一种无呼吸抑制的有用方法。
