TOTAL IV ANESTHESIA WITH PROPOFOL AND ALFENTANIL - DOSE REQUIREMENTS FOR PROPOFOL AND THE EFFECT OF PREMEDICATION WITH CLONIDINE

被引:63
作者
RICHARDS, MJ [1 ]
SKUES, MA [1 ]
JARVIS, AP [1 ]
PRYSROBERTS, C [1 ]
机构
[1] UNIV BRISTOL,BRISTOL ROYAL INFIRM,SIR HUMPHRY DAVY DEPT ANAESTHESIA,BRISTOL BS2 8HW,AVON,ENGLAND
关键词
Anaesthetic techniques: infusion; Anaesthetics intravenous: propofol; Analgesics opioid: alfentanil; Sympathetic nervous system: clonidine;
D O I
10.1093/bja/65.2.157
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We determined in 51 healthy patients undergoing body surface surgery the dose requirements for propofol, as part of a total i.v. anaesthesia technique with an alfentanil infusion. After premedication with temazepam, patients received alfentanil 50 μg kg-1 followed by an infusion of 50 μg kg-1 h-1. Patients were anaesthetized with a loading dose of propofol followed by a three-stage infusion designed to reach one of five preselected blood concentrations of propofol. The motor response to the initial surgical incision was noted and probit analysis was used to derive the ED50 (2.94 mg kg-1 h-1; 95% confidence limits: 2.35-3.37 mg kg-1 h-1). and ED95 (4.98 mg kg-1 h-1; 95% limits: 4.13-8.8 mg kg-1 h-1) for the final propolol infusion rate under these conditions. Whole blood concentration of propofol at the time of the incision was related linearly to the infusion rate and the EC50 and EC95 (probit analysis) were derived as 1.44 (95% confidence limits 0.62-1.87) and 4.05 (95% confidence limits 2.78-30.5) μg ml-1, respectively. Postoperative recovery was rapid, uncomplicated and uneventful. In a subgroup of eight patients, the addition of clonidine 0.6mg to the premedication significantly decreased the requirement for propofol (P <0.05) during surgery, but resulted in prolonged recovery times. © 1990 Copyright: 1990 British Journal of Anaesthesia.
引用
收藏
页码:157 / 163
页数:7
相关论文
共 29 条
[21]   DOSE-RESPONSE RELATIONSHIPS FOR INFUSIONS OF ALTHESIN OR METHOHEXITONE [J].
SEAR, JW ;
PHILLIPS, KC ;
ANDREWS, CJH ;
PRYSROBERTS, C .
ANAESTHESIA, 1983, 38 (10) :931-936
[22]  
SEAR JW, 1988, ANAESTHESIA S, V43, pS18
[23]   PHARMACOKINETICS AND PHARMACODYNAMICS OF PROPOFOL INFUSIONS DURING GENERAL-ANESTHESIA [J].
SHAFER, A ;
DOZE, VA ;
SHAFER, SL ;
WHITE, PF .
ANESTHESIOLOGY, 1988, 69 (03) :348-356
[24]  
SKUES MA, 1989, ANESTH ANALG, V69, P386
[25]   DOSE REQUIREMENTS OF PROPOFOL BY INFUSION DURING NITROUS-OXIDE ANESTHESIA IN MAN .1. PATIENTS PREMEDICATED WITH MORPHINE-SULFATE [J].
SPELINA, KR ;
COATES, DP ;
MONK, CR ;
PRYSROBERTS, C ;
NORLEY, I ;
TURTLE, MJ .
BRITISH JOURNAL OF ANAESTHESIA, 1986, 58 (10) :1080-1084
[26]   COMPUTER-CONTROLLED INFUSION OF PROPOFOL [J].
TACKLEY, RM ;
LEWIS, GTR ;
PRYSROBERTS, C ;
BOADEN, RW ;
DIXON, J ;
HARVEY, JT .
BRITISH JOURNAL OF ANAESTHESIA, 1989, 62 (01) :46-53
[27]   DOSE REQUIREMENTS OF PROPOFOL BY INFUSION DURING NITROUS-OXIDE ANESTHESIA IN MAN .2. PATIENTS PREMEDICATED WITH LORAZEPAM [J].
TURTLE, MJ ;
CULLEN, P ;
PRYSROBERTS, C ;
COATES, D ;
MONK, CR ;
FAROQUI, MH .
BRITISH JOURNAL OF ANAESTHESIA, 1987, 59 (03) :283-287
[28]   CLONIDINE PREMEDICATION FOR ISOFLURANE-INDUCED HYPOTENSION - SYMPATHOADRENAL RESPONSES AND A COMPUTER-CONTROLLED ASSESSMENT OF THE VAPOR REQUIREMENT [J].
WOODCOCK, TE ;
MILLARD, RK ;
DIXON, J ;
PRYSROBERTS, C .
BRITISH JOURNAL OF ANAESTHESIA, 1988, 60 (04) :388-394
[29]  
1985, PROBIT TRANSFORMATIO