术前耐痛阈与丙泊酚靶控输注镇静的关系

摘要

Objective To explore the correlative changes between preoperative pain tolerance and target-controlled infusion( TCI )sedation with propofol , providing information to administrate general anesthesia for individual. Methods Seventy patients with intravenous target-controlled infusion. The target-controlled concentration of propofol in effect site was set at 1μG/ml until it was maintained equilibrium for 2 minutes between the target-controlled concentration in plasma and the target-controlled concentration in effect site. Then the target-controlled concentration in effect site was increased by 0. 5 μg/ml each time until OAA/S reached to 3 points. Patients based on blood pressure ,heart rate , SpO2 were recorded. The target-controlled concentration in effect site , blood pressure and heart rate were recorded respectively when sedative depth reached 3 points. Results Preoperative pain threshold was related positively with TCI in effect site when sedative depth reached OAA/S3( P ＜0. 01 ). Conclusion The higher the pain threshold,the higher the TCI in effect site when sedative depth reached 3 points,which may provide information to administrate general anesthesia for individual.%目的 探讨术前耐痛阈与丙泊酚靶控输注(TCI)镇静的关系,为全身麻醉的个体化用药提供参考.方法 70例患者静脉靶控输注丙泊酚,血药浓度从1 μg/ml开始,待血浆靶控浓度与效应室靶控浓度达到平衡时维持2 min,加大效应室靶浓度,每次上调0.5 μg/ml直到患者警觉/镇静评分(OAA/S)评分达到3分.记录患者基础血压、心率;OAA/S评分3分时对应的效应室计算值、血压、心率.结果 病人术前耐痛阈与丙泊酚TCI镇静使患者达到OAA/S评分3分时效应室计算值呈显著正相关(P＜0.01).结论 病人术前耐痛阈越高,丙泊酚TCI镇静使患者达到OAA/S评分3分所需要的效应室浓度越高,为全身麻醉个体化用药提供参考.