Clinical assessment of target-controlled infusion of propofol during monitored anesthesia care

被引:49
作者
Casati, A [1 ]
Fanelli, G [1 ]
Casaletti, E [1 ]
Colnaghi, E [1 ]
Cedrati, V [1 ]
Torri, G [1 ]
机构
[1] Univ Milan, IRCCS H San Raffaele, Dept Anesthesiol, I-20132 Milan, Italy
来源
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE | 1999年 / 46卷 / 03期
关键词
D O I
10.1007/BF03012602
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose: To determine the plasma concentrations of propofol required to achieve different levels of sedation during monitored anesthesia care. Methods: Sixty ASA I-II, 18-65 yr-old patients, received a target-controlled continuous iv infusion of propofol. The target plasma concentration of propofol (Cp-t) was initially set at 0.4 mu g.ml(-1). Two minutes after calculated equilibrium between plasma and effect-site concentrations, the Cp-t of propofol was increased by 0.2 mu g.ml(-1) steps until the patient showed no reaction to squeezing the trapezius. The level of sedation was assessed immediately before each increase in propofol Cp-t using the Observer's Assessment of Alertness/Sedation (OAA/S) scale. Results: The Cp-t of propofol required to induce lethargic response to name was 1.3 mu g.ml(-1) (5 degrees and 95 degrees percentiles: 1.0 - 1.8 mu g.ml(-1)), to obtain response after loud and repeated calling name was 1.7 mu g.ml(-1) (1,2 - 2.2 mu g.ml(-1)), to obtain response after prodding or shaking was 2.0 mu g.ml(-1) (1.6 - 2.6 mu g.ml(-1)), tc,obtain response after squeezing the trapezius was 2.4 mu g.ml(-1) (1.8 - 3.0 mu g.ml(-1)). Patients showed no response after squeezing the trapezius at 2.8 mu g.ml(-1) (2.0 - 3.6 mu g.ml(-1)). Correlation between Cp-t propofol and sedation scores were r = 0.76, P < 0.0001. Conclusions: Target-controlled infusion of propofol provided easy and safe management of intraoperative sedation, allowing fast and predictable deepening in the level of sedation, while minimizing systemic side effects of intravenous sedation due to the minimal risk of overdosing the drug.
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页码:235 / 239
页数:5
相关论文
共 22 条
[1]   METHODS FOR MONITORING THE LEVEL OF SEDATION [J].
AVRAMOV, MN ;
WHITE, PF .
CRITICAL CARE CLINICS, 1995, 11 (04) :803-&
[2]  
CHERNIK DA, 1990, J CLIN PSYCHOPHARM, V10, P244
[3]   PHARMACOKINETIC MODEL SELECTION FOR TARGET CONTROLLED INFUSIONS OF PROPOFOL - ASSESSMENT OF 3 PARAMETER SETS [J].
COETZEE, JF ;
GLEN, JB ;
WIUM, CA ;
BOSHOFF, L .
ANESTHESIOLOGY, 1995, 82 (06) :1328-1345
[4]  
Fanelli G, 1992, Minerva Anestesiol, V58, P1025
[5]   A double-blind comparison of ropivacaine, bupivacaine, and mepivacaine during sciatic and femoral nerve blockade [J].
Fanelli, G ;
Casati, A ;
Beccaria, P ;
Aldegheri, G ;
Berti, M ;
Tarantino, F ;
Torri, G .
ANESTHESIA AND ANALGESIA, 1998, 87 (03) :597-600
[6]  
GEPTS E, 1987, ANESTH ANALG, V66, P1256
[7]  
Glass PJ, 1990, ANESTHESIA, P367
[8]   The development of 'Diprifusor': a TCI system for propofol [J].
Glen, JB .
ANAESTHESIA, 1998, 53 :13-21
[9]   SEDATIVE-HYPNOTICS AND HUMAN-PERFORMANCE [J].
JOHNSON, LC ;
CHERNIK, DA .
PSYCHOPHARMACOLOGY, 1982, 76 (02) :101-113
[10]   PHARMACOKINETIC MODEL DRIVEN INFUSION OF PROPOFOL IN CHILDREN [J].
MARSH, B ;
WHITE, M ;
MORTON, N ;
KENNY, GNC .
BRITISH JOURNAL OF ANAESTHESIA, 1991, 67 (01) :41-48