Objective:To evaluate the predictive performance of‘Diprifusor’TCI(target-controlled infusion)system for its betterapplication in clinical anesthesia.Methods:The predictive performance of a‘Diprifusor’TCI system w...Objective:To evaluate the predictive performance of‘Diprifusor’TCI(target-controlled infusion)system for its betterapplication in clinical anesthesia.Methods:The predictive performance of a‘Diprifusor’TCI system was investigated in 27Chinese patients(16 males and 11 females)during upper abdominal surgery under total intravenous anesthesia(TIVA)withpropofol/fentanyl.Measnred arterial propofol concentrations were compared with the values predicted by the TCI infusion system.Performance was determined by the median performance error(MDPE),the median absolute performance error(MDAPE),thedivergence(the percentage change of the absolute PE with time),and the wobble(the median absolute deviation of each PE fromthe MDPE).Results:The median(range)values of 14.9%(-21.6%～42.9%)for MDPE,23.3%(6.9%～62.5%)for MDAPE,-1.9%h^(-1)(-32.7%～23.0% h^(-1))for divergence,and 18.9%(4.2%～59.6%)for wobble were obtained from 227 samples from all patients.For the studied population,the PE did not increase with time but with increasing target propofol concentration,particularly fol-lowing induction.Conclusions:The control of depth of anaesthesia was good in all patients undergoing upper abdominal surgicaloperation and the predictive performance of the‘Diprifusor’target controlled mthsion system was considered acceptable forclinical purposes.But the relatively bigger wobble showed that the pharmacokinetic model is not so suitable and requires im-provement.展开更多
AIM:To compare the endomicroscopic image quality of integrated confocal laser endomicroscopy(iCLE)and sedation efficacy of propofolvs midazolam plus fentanyl(M/F).METHODS:Consecutive outpatients undergoing iCLE were p...AIM:To compare the endomicroscopic image quality of integrated confocal laser endomicroscopy(iCLE)and sedation efficacy of propofolvs midazolam plus fentanyl(M/F).METHODS:Consecutive outpatients undergoing iCLE were prospectively recruited and randomized to the propofol group(P group)or M/F group.The patient,performing endoscopist and endoscopic assistant were blinded to the randomization.The quality of endomicro-scopic images and anesthetic efficacy outcomes were blindly evaluated after iCLE examination.RESULTS:There were significantly more good quality endomicroscopic images in the propofol group than in the M/F group(72.75%vs 52.89%,P<0.001).The diagnostic accuracy for upper gastrointestinal mucosal lesions using confocal laser endomicroscopy favors the P group,although this did not reach statistical significance.Adverse events and patient assessment were not significantly different for M/F vs propofol except for more frequent intraprocedural recall with M/F.Procedure duration and sedation times were significantly longer in the M/F group,while the scores of endoscopist,anesthetist and assistant assessment were all significantly better in the P group.CONCLUSION:Sedation with propofol might increase the proportion of good quality endomicroscopic images,and may result in improved procedural efficacy and diagnostic accuracy during iCLE examination.展开更多
文摘Objective:To evaluate the predictive performance of‘Diprifusor’TCI(target-controlled infusion)system for its betterapplication in clinical anesthesia.Methods:The predictive performance of a‘Diprifusor’TCI system was investigated in 27Chinese patients(16 males and 11 females)during upper abdominal surgery under total intravenous anesthesia(TIVA)withpropofol/fentanyl.Measnred arterial propofol concentrations were compared with the values predicted by the TCI infusion system.Performance was determined by the median performance error(MDPE),the median absolute performance error(MDAPE),thedivergence(the percentage change of the absolute PE with time),and the wobble(the median absolute deviation of each PE fromthe MDPE).Results:The median(range)values of 14.9%(-21.6%～42.9%)for MDPE,23.3%(6.9%～62.5%)for MDAPE,-1.9%h^(-1)(-32.7%～23.0% h^(-1))for divergence,and 18.9%(4.2%～59.6%)for wobble were obtained from 227 samples from all patients.For the studied population,the PE did not increase with time but with increasing target propofol concentration,particularly fol-lowing induction.Conclusions:The control of depth of anaesthesia was good in all patients undergoing upper abdominal surgicaloperation and the predictive performance of the‘Diprifusor’target controlled mthsion system was considered acceptable forclinical purposes.But the relatively bigger wobble showed that the pharmacokinetic model is not so suitable and requires im-provement.
基金Supported by Grants from Ministry of Health of China(2010)Shandong Province Science and Technology Committee,No.2007BSB02087Graduate Independent Innovation Fund of Shandong University
文摘AIM:To compare the endomicroscopic image quality of integrated confocal laser endomicroscopy(iCLE)and sedation efficacy of propofolvs midazolam plus fentanyl(M/F).METHODS:Consecutive outpatients undergoing iCLE were prospectively recruited and randomized to the propofol group(P group)or M/F group.The patient,performing endoscopist and endoscopic assistant were blinded to the randomization.The quality of endomicro-scopic images and anesthetic efficacy outcomes were blindly evaluated after iCLE examination.RESULTS:There were significantly more good quality endomicroscopic images in the propofol group than in the M/F group(72.75%vs 52.89%,P<0.001).The diagnostic accuracy for upper gastrointestinal mucosal lesions using confocal laser endomicroscopy favors the P group,although this did not reach statistical significance.Adverse events and patient assessment were not significantly different for M/F vs propofol except for more frequent intraprocedural recall with M/F.Procedure duration and sedation times were significantly longer in the M/F group,while the scores of endoscopist,anesthetist and assistant assessment were all significantly better in the P group.CONCLUSION:Sedation with propofol might increase the proportion of good quality endomicroscopic images,and may result in improved procedural efficacy and diagnostic accuracy during iCLE examination.
