体外循环对靶控输注丙泊酚血药浓度的影响金鑫崔剑顾健腾陶国才.docVIP

体外循环对靶控输注丙泊酚血药浓度的影响 金鑫 崔剑 顾健腾 陶国才* 【摘要】 目的 观察体外循环对靶控输注(TCI) 丙泊酚血药浓度的影响。方法 13例ASAⅡ—Ⅳ级择期行双瓣置换术患者，术中持续静脉TCI丙泊酚，靶浓度（Cp）维持2 μg/ml，并于人工心肺（CPB）转机前（T0）、转机后3 min（T1）、8 min（T2）、15 min（T3）、30 min（T4）、60 min（T5）采集动脉血2 ml，采用高效液相色谱一荧光法测定丙泊酚血药浓度(Cm),同时测定血红蛋白(hemoglobin, Hb)和血球压积(hematocrit, Hct)。同时连续监测患者的肛温(rectal temperature,RT)及其他生命体征。结果 体外循环转机过程中，T1-T5的Hb、Hct及肛温（RT）均较转机前明显降低，但以T3后温度变化更加明显（P﹤0.05）Effect of CPB on plasma concentration of propofol administered TCI JIN Xin,TAO Guo-cai*,CUI Jian,et al.*Department of Anesthesiology,Southwest Hospital, Third Military Medical University, Chongqing .400038 【Abstract】 Objective To investigate the effect of CPB on concentration of propofol administered by TCI. Method Randomized 13 ASAⅡ-Ⅳ patients aged 16-60yr weighting 40-75kg undergoing bicuspid valve and aortic valve replacement. Radial artery and right internal jugular vein were cannulated before induction of anesthesia for MAP and CVP monitoring.All the patients were performed TCI of propofol after induction 10min later. The target plasma concentration of propofol (Cp)was set at 2ug/ml by Diprifusor TCI system..While beginning of CPB, acute hemodilution was going with hypothermia by infusing 4% gelofusine. Arterial blood samples were taken before CPB（T0）, and at 3min（T1）,8min（T2）,15min（T3）, 30min（T4）and 60min（T5）after it for determination of plasma concentration of propofol by HPLC.And determination Hct and Hb at the same time . The vital signs that they were MAP ,HR,P,CVP, ECG,ETCO2, SPO2 NT(temperature of nasal cavity) and RT (rectal temperature) were continuously monitored during the anesthesia.Results After CPB , Hb and Hct of T1-T5 were lower than the initial values,they decreased significantly,but they(T1-T5) were no difference. At the same time , RTs were decreased gradually , especially T3.As measured blood propofol concentrations(Cm) of T1-T3 were significantly lower at T4 and T5,then we could part them into two group at T3, Cm of T1-T3 were all lower than T0 obviousl