丙泊酚闭环麻醉的临床应用

Clinical Application of Closed-Loop Target Controlled Infusions of Propofol

丙泊酚闭环麻醉将靶控输注技术与监测麻醉深度的脑电双频指数有机结合,通过反馈机制维持设定的麻醉深度。目前丙泊酚闭环麻醉已应用于全身麻醉、镇静麻醉以及与其他麻醉方式相结合的联合麻醉。丙泊酚闭环麻醉不仅可用于身体条件较好的一般患者,也可用于老年、小儿、肥胖及重症患者,并能有效避免麻醉过深。丙泊酚闭环麻醉可以维持稳定的麻醉深度,避免麻醉过深或过浅,术后谵妄和认知功能障碍的发生率降低,但其总的给药量与是否使用闭环麻醉无相关性。各种因素对脑电双频指数的影响以及反馈的延迟导致了丙泊酚闭环麻醉的局限性。

The closed-loop anesthesia of propofol combines the target controlled infusion technique with bispeetral index which monitors the depth of anesthesia,and maintains the depth of anesthesia through the feedback meehanisnm At present, the closed-loop propofol anesthesia has been applied in general anesthesia, sedation anesthesia and combined anesthesia. The closed-loop anesthesia of propofol not only can be used in the general patients,but also can be used in the elderly,the children,the obese and the severe patients,which can effectively avoid the deep anesthesia. The closed-loop propofol anes-thesia can maintain the depth of anesthesia, avoid deep or shallow anesthesia, and reduce the incidence of postoperative delirium and cognitive dysfunction. However,the total dose of propofol is not correlated with the use of closed-loop anesthe-sia. The effects of various factors on bispeetral index and delayed feedback are the limitations of using closed-loop propofol anesthesia.