摘要
Abstract
Objective To explore the impact of gender on plasma concentration and pharmacodynamics of propofol by target controlled infusion (TCI) during anesthetic recovery.Methods Eighteen patients (ASA grade Ⅰ or Ⅱ) who would undergo otolaryngology surgery were enrolled and divided into male group and female group according to gender with 9 cases in each group.During the anesthesia induction and surgery period,propofol was infused by TCI system incorporating the Marsh model.After the surgery was finished,the moment the patients entered the post anesthesia care unit,target effect site concentration (Ce) was gradiently decreased,blood samples were taken at 0,10,20,30,60,90 and 120 min after patients entered the postanesthesia care unit,the plasma concentrations of propofol were determined by HPLC,the difference among measured plasma concentration (Cm),target plasma concentration (Cp) and Ce were compared,and the alertness/sedation scale was simultaneous assessed.Results The Cm of propofol were lower than Cp at each time points in the two groups during the anesthetic recovery period.The Cm of male group were significantly lower than Cp at 30 min time point(P ＜0.05),the Cm of female group were significantly lower than Cp at 10-90 min time points (P ＜ O.05).There was no statistically significant difference of Ce and Cp between the male and female groups (P ＞ 0.05).The Cm of female group were lower than male group at each time point,and there were significant differences at 0,10 min time points between the two groups(P ＜0.05).The Cm of female group were(4.37 ±0.90),(1.71 ±0.52) μg · mL-1,and the Cm of male group were (5.04 ±0.93),(2.10 ±0.37) μg · mL-1 at 0,10 min respectively.The median prediction performance error was-17.27％ in female group and-12.25％ in male group,and the median absolute performance error was 28.01％ and 22.98％,respectively.The alertness/sedation scales of female group were higher than male group at 10-60 min time points,but there were no significant difference (P ＞ 0.05),the alertness/sedation scales were same at the other time points.Conclusion In the anesthetic recovery period,the deviation between the measured and target plasma concentration of propofol was larger in female than in male,suggesting that gender has significant impact on plasma concentration of propofol,the impact of gender on pharmacokinetics was not significant.关键词
丙泊酚/靶控输注/性别/血药浓度/药效学Key words
propofol/target controlled infusion/gender/plasma drug concentration/pharmacodynamics分类
医药卫生
