丙泊酚靶控输注在外科ICU病人清醒镇静中的应用

Application of target-controlled infusion with propofol for conscious sedation of SICU patients

目的探讨丙泊酚靶控输注(TCI)应用于外科ICU(SICU)病人清醒镇静的可行性.方法60例SICU病人随机分成四组:C组使用普通微泵连续输注丙泊酚,2 mg·kg-1·h-1;Ⅰ～Ⅲ组均使用Diprifusor TCI系统输注丙泊酚,TCI浓度分别为0.5、1.0、1.5 μg/ml.监测不同时点的脑电双频指数(BIS),记录出现的不良反应,并对所有病人进行镇静/警醒评分.结果Ⅰ组各时点的镇静评分、BIS均高于Ⅱ、Ⅲ组和C组(P＜0.05);Ⅱ、Ⅲ组低血压、镇静不足、过度镇静的发生率比C组少(P＜0.05);Ⅰ组的镇静不足发生率高于Ⅱ、Ⅲ组(P＜0.05).结论丙泊酚TCI应用于SICU病人清醒镇静对呼吸循环影响小,镇静效果理想,操作便利.

Objective To investigate the feasibility of target-controlled infusion （TCI）with propofol for conscious sedation of SICU patients. Methods Sixty patients in SICU were randomly divided into four groups with 15 cases each. Patients in group C received intravenous continuous transfusion of propofol at the rate of 2 mg · kg^-1· h^-1. The patients in group Ⅰ , Ⅱ , Ⅲ were sedated by propofol TCI in a rate of 0. 5, 1.0,or 1.5 μg/ml respectively. The values of BIS, OAA/S scoles, and adverse reaction were recorded. Results OAA/S scoles and BIS were significantly higher in group Ⅰ than those in the other groups（P〈0. 05）. The incidences of hypotension,insufficient sedation or oversedation were significantly higher in group Ⅰ than those in group Ⅱ and Ⅲ （P〈0. 05）. Conclusion TCI with propofol for conscious sedation of SICU patients has the advantages of less hemodynamic and respiratory effect, appropriate sedation, and easy proctise.