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吸入七氟烷对闭环系统控制的丙泊酚经静脉麻醉效果影响的研究

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吸入七氟烷对闭环系统控制的丙泊酚经静脉麻醉效果影响的研究

作者:周权周然刘宇吴安石岳云

来源:《上海医药》2015年第05期

摘 ; 要 ; 目的:探讨吸入麻醉对闭环系统控制的经静脉麻醉效果的影响。方法:17例择期上腹部开腹手术患者接受CONCERT-CL闭环系统控制的丙泊酚经静脉麻醉。术中平稳阶段,Drager Zeus麻醉机自动完成预设的呼气末七氟醚浓度。观察七氟烷在达0.0、0.4、0.7和1.0个最低肺泡有效浓度(minimum alveolar concentration, MAC)后平衡5 min时的脑电双频谱指数(bispectral index, BIS)值以及丙泊酚的血浆和效应室浓度,同时记录血压和心率。结

果:丙泊酚血浆和效应室浓度随七氟烷浓度升高而明显下降(P均

关键词 ; ;闭环麻醉 ; ;丙泊酚 ; ;七氟烷 ; ;脑电双频谱指数

中图分类号:R614.2 ; ; ; ; ; ;文献标识码:B ; ; ; ; ; ;文章编号:1006-1533(2015)05-0015-04

The effect of sevoflurane on the efficiency

of a closed-loop control system for propofol anesthesia

Zhou Quan, ZHOU Ran, LIU Yu, WU Anshi, YUE Yun*

(Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University,Beijing 100020, China)

Abstract ; Objective: To investigate the effect of inhalational anesthesia on the efficiency of a closed-loop control system for intravenous anesthesia. Methods: A CONCERT-CL closed-loop control system for propofol anesthesia was applied in 17 patients with elective upper abdominal laparotomy. During stationary phase, sevoflurane was automatically delivered by Drager Zeus anesthesia machine. After equilibrium of sevoflurane [0.0, 0.4, 0.7, 1.0 minimum alveolar concentration (MAC)] for 5 min, the plasma and effect-site concentrations of propofol and bispectral index (BIS) were monitored and meanwhile the blood pressure and heart rate were recorded. Results: The plasma and effect-site concentrations of propofol decreased significantly when sevoflurane increased (P<0.01). Due to the design of the closed-loop control system, a minimum target concentration of propofol is 1.0 mg/ml. When sevoflurane reached at 1.0 MAC, the effect-site concentration of propofol decreased to 1.0 mg/ml in 12 cases (70.6%), beyond the scope of the closed-loop control system. When sevoflurane reached at 0.4 or 0.7 MAC, BIS values were remained within a predetermined range of 40~60 with only one case less than 40 (38.86).

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