摘要
目的 研究年龄对异丙酚药效学的影响。方法 选择 18～ 90岁ASAⅠ～Ⅱ级择期手术患者 42例 ,按年龄分成 :A组 18～ 34岁 (14例 )、B组 35～ 6 0岁 (15例 )、C组 >6 0岁 (13例 )三组 ,腰麻完善后 ,A组以 0 5mg·kg-1·min-1的速率 ,B、C组以 0 4mg·kg-1·min-1的速率静脉输注异丙酚 ,EEG爆发抑制时停止给药 ,取一系列静脉血样本用于测异丙酚血药浓度。意识消失时间、睡眠时间、达到爆发抑制时的用药量、意识消失和意识恢复时的血药浓度与年龄的关系用直线回归进行分析 ,年龄对意识消失和意识恢复与血药浓度关系的影响用曲线回归分析。结果 C组比A、B组意识消失时间短 ,用药量小。老年人对异丙酚的敏感性增加 ,2 5岁 ,5 0岁 ,75岁意识消失EC5 0值分别为 2 86 ,2 2 6和 1 78μg·ml-1,而意识恢复的EC5 0值分别为 1 76 ,1 45 ,1 11μg·ml-1。结论 异丙酚对老年患者催眠和EEG效应比青年人更敏感 。
Objective To study the influence of age on the pharmacodynamics of propofol including the relationship between plasma concentrations of propofol and the time of loss of consciousness or return of consciousness.Methods Forty-two ASAⅠ-Ⅱ patients were assigned to one of three age groups: group A: age ranged from 18-34 yr(n=14); group B:35-60 yr(n=15); and group C: 61-90 yr(n=13). Once spinal anesthesia was completed, propofol infusion at the rate of 0.5 mg·kg -1·min -1(group A) or 0.4 mg·kg -1·min -1(group B and C )was started until burst suppression of EEG lasting 3s was observed. Venous blood samples were taken at 1, 2, 4, 8,10, 15, 30, 45,60,90,120 and 240 min after the start of propofol infusion for the determination of plasma propofol concentrations. The influence of age on relationship between propofol plasme concentration and loss of consciousness or return of consciousness was analyzed by non-linear regression. The relationships between age and time of loss of consciousness,duration of sleep,the total dose of propofol,the plasma concentration at the time of loss of consciousness or return of consiousness were determined by linear regression.Results As compared with those in group A and B,the time of loss of consciousness and the total dose of propofol required decreased markedly in group C. The observation showed increased sensitivity to propofol in elderly patients. The EC50 values for loss of consciousness were 2.86 (at age of 25 yr),2.26 (at 50yr), and 1.78 (at 75yr) μg·ml -1,and the EC50 values for return of consciousness of 1.76 (at 25 yr),1.45(at 50yr),1.11(at 75yr)μg·ml -1 respectively.Conclusions Elderly patients are more sensitive to propofol than younger people in terms of hypnosis and EEG effects.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2001年第3期146-148,共3页
Chinese Journal of Anesthesiology
