Pharmacodynamic interaction between fentanyl and propofol administered by target-controlled infusion
- VernacularTitle:靶控输注芬太尼复合异丙酚静脉麻醉的药效学
- Author:
Qingsong HOU
;
Xing XU
;
Xinmin WU
- Publication Type:Journal Article
- Keywords:
Fentanyl;
Propofol;
Anesthesia, intravenous;
Drug delivery systems;
Dose-responserelationship, drug
- From:
Chinese Journal of Anesthesiology
1995;0(10):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the dose-effect curve of fentanyl with respect to the suppression of somatic or hemodynamic responses to skin incision when plasma propofol concentration was maintained at 3 ?g?ml-1 by target-controlled infusion (TCI) .Methods Twenty-four ASA Ⅰ-Ⅱ patients aged 31-65 yrs undergoing elective surgery under general anesthesia were enrolled in this study. Anesthesia was induced with TCIs of fentanyl and propofol. The patients were randomized to receive fentanyl by TCI at a target plasma concentration of 1.0, 1.5, 2.25 or3.38 ng?ml-1 . The target plasma propofol concentration was set at 3 ?g?ml-1 in all patients. The patients were intubated when the patients failed to respond to verbal command and eyelash reflex was lost. Tracheal intubation was facilitated with succinylcholine 1 mg?kg-1. MAP, HR, ECG and SpO2 were monitored before and during anesthesia. The duration between the start of TCIs and skin incision was longer than 30 min for fentanyl and 15 min for propofol to ensure that the effect-site drug concentrations reached the steady-state. The changes in BP and HR and body / limb movement and other signs of inadequate depth of anesthesia like lacrimation, flushing and sweating during and immediately after skin incision were recorded. The fentanyl plasma concentrations (predicted target concentration) at which 50% of the patients did not respond to skin incision (Cp50) were calculated. Results The Cp50 of fentanyl based on somatic response was 1.84 ng?ml-1 . Its 95% confidince interval ranged from 1.46 ng?ml-1 to 2.33 ng?ml-1 . The Cp50 of fentanyl based on hemodynamic response was 2.67 ng?ml-1 with a 95% confidence interval from 1.96 ng?ml-1 to3.62 ng?ml-1. Conclusion When anesthesia is induced with TCIs of propofol and fentanyl, if target plasma propofol is set at 3 ?g?ml-1 , target fentanyl plasma concentration should be set at least at 5.12 ng?ml-1 to ensure adequate depth of anesthesia for skin incision.
