连续硬膜外麻醉时异丙酚辅助用药及血药浓度监测

PROPOFOL AS AN ADJUNCT TO EPIDURAL ANESTHESIA AND ITS BLOOD CONCENTRATION MEASUREMENT

目的：探讨异丙酚连续硬膜外麻醉时辅助用药的方法及其药代动力学特性。方法：30例下腹部或下肢手术病人随机分为两组，在连续硬膜外麻醉下分别以不同速度静滴异丙酚，同时高压液相法测定血药浓度。结果：以10→8→5mg／（kg·h）方法给药，患者意识消失明显快于5mg／（kg·h）恒速给药组（P＜0.05）。平均意识消失及苏醒血药浓度分别为（2．1±0．7）mg／L及（1．0±0．5）mg／L。结论：连续硬膜外麻醉时辅助用药以10→8→5mg／（kg·h）的给药方法为佳。为避免术中病人觉醒，最低给药速度不得低于5mg／（kg·h）。

objective: Propofol as an adjunct to epidural anaesthesia and its pharmacokinetic properties were studied. Metbods: 30 lower limb or lower abdominal surgical patients were subdivided into two groups with an open random sequences. Propofol was administered at a different rate in infusion under epidural anesthesia. Blood concentrations were determined by high-performance liquid chromatography with fluorescence detection. Results: When propofol was given at the rate of 10→8→5 mg/(kg · h),the time from the start of infusion to unconsciousness was shorter than that of the group of 5 mg/(kg.h) (P<0. 05). The mean blood concentration of propofol was (2.1±0. 7) mg/L at the onset of unconsciousness and (1. 0±0. 5) mg/L on awakening. Concluslon: The method of propofol infusion at the rates of 10→8→5 mg/(kg·h) was better than that of 5 mg/(kg·h). The rate Bhould not be slower than 5 mg/(kg·h) to avoid patient awaking during surgeries.