程序输注在临床麻醉中的应用

The clinical study of programmed infusion system in anesthesia

目的 提高静脉麻醉的可控性。方法 选择２０ 例ＡＳＡⅠ级病人，以普鲁卡因为麻醉药，分别实施单纯指数衰减程序输注及Ｗａｎｇｅｒ 两相相继恒速程序输注。结果 单纯组约１０ ｍｉｎ（５ 个分布半衰期） 血药浓度达到并维持预期稳态血药水平，中位数执行误绝对值（ＭＤＡＰＥ） 为１２．４％ ；两相组快滴１５ ｍｉｎ 后血药浓度波动在预期稳态水平，ＭＤＡＰＥ为１７．４％ 。２ 组程序输注前后对血流动力学指标（ 平均动脉压、心率） 均无明显影响（ Ｐ＞０．０５） 。结论 ２ 种程序输注临床实施是安全、有效的，从总体指标看单纯组优于两相组。

Objective To enhance the control-ability of intravenousanesthesia. Methods 20 ASAⅠ-Ⅱ patients were divided randomly into 2 groups: in group Ⅰ(n=10),procaine was infused to a desired level by the single exponentially declining model;in group Ⅱ(n=10),procaine was infused by two constant rates programmed infusion.The anesthesia was maintained with complex isoflurance and procaine. Results ① The concentration of procaine reached the desired level in 10～15 min in the 2 groups.② The median of absoluted performance error was 12.4% in group Ⅰand 17.4% in group Ⅱ.③ The cardiovascular systems was stable during the programmed infusion.Conclusion ① The 2 programmed infusion system were safe and effective in clinical practice.② The single exponentially declining infusion is more convenient and accurate than the two constant rates programmed infusion.