Pharmacodynamic effect of propofol by target controlled infusion in patients with different liver functions
10.3877/cma.j.issn.2095-3232.2015.05.011
- VernacularTitle:肝功能不同患者靶控输注丙泊酚的药效反应
- Author:
Jingru PAN
1
;
Xinjin CHI
;
Wanling GAO
;
Shaoli ZHOU
;
Ziqing HEI
Author Information
1. 中山大学附属第三医院麻醉科
- Keywords:
Hepatic insufficiency;
Anesthesia;
Target controlled infusion;
Propofol;
Hemodynamics
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2015;(5):301-305
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo observe the pharmacodynamic effect of propofol by target controlled infusion (TCI) in patients with different liver functions during surgery.MethodsSixty patients undergoing laparotomy under general anesthesia with endotracheal intubation in the Third Affiliated Hospital of Sun Yat-sen University between June 2013 and June 2014 were enrolled in this prospective study. Among the 60 patients, 51 were males and 9 were females with the age ranging from 18 to 70 years old and the median of 48 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into 4 groups according to the Child-Pugh liver function grading, the normal liver function group (N group,n=7), grade A group (A group, n=21), grade B group (B group,n=20) and grade C group (C group,n=12). TCI propofol were given to all patients during the operation with the target plasma concentration of 3 μg/ml. Bispectral index (BIS) and hemodynamic parameters of the 4 groups during the anesthesia induction period (within 30 min of TCI) were recorded. The percentage of patients with BIS dropped below 40 and the incidence of hemodynamic events in each group were compared. The comparison was conducted using Chi-square test or Fisher's exact test.ResultsDuring the anesthesia induction period, BIS of the 4 groups dropped with time and was stable at 20 min. The percentage of patients with BIS below 40 in N, A, B and C group was respectively 9.2%, 11.2%, 20.4% and 26.8%, C group was signiifcantly higher than N and A group (χ2=12.28, 18.81;P<0.05). During the anesthesia induction period, the incidence of hypotension in N, A, B and C group was respectively 0, 5%, 8% and 16%, C group was signiifcantly higher than N, A and B group (P<0.0001, P<0.0001,P=0.0195). The incidence of bradycardia in N, A, B and C group was respectively 15%, 5%, 3% and 0, C group was significantly lower than N, A and B group (P<0.0001,P=0.0003,P=0.0085). ConclusionsSimilar trends of change in anesthesia depth are observed in patients with different liver function when using propofol TCI, but patients with severe hepatic dysfunction may more likely to develop fulminant suppression of brain wave and hypotension.
