低剂量普罗波作为单独的镇静剂在术后呼吸肝移植接受者:一个初步的观察性研究
Rishabh Jaju1, Kelika Prakash2, M K Arora3
1Department of Anaesthesia and Critical Care, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
Journal of anaesthesiology, clinical pharmacology
|May 30, 2023
概括
肝移植后的患者需要较低剂量的 пропофол进行镇静. 这项研究发现,活体供体肝移植接受者需要比标准剂量更少的普罗波来进行有效的镇静.
科学领域:
- 麻醉学 麻醉学
- 肝病学 肝病学是一种肝病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 肝移植 (LT) 改变了药物代谢,原因是肝脏质量,血流,蛋白质水平和再生的变化.
- 标准的普罗波福尔剂量 (1.5-4.5 mg.kg−1.h−1) 可能对LT后的患者来说不是最佳的.
- 改变的药理动力学需要评估在这个人群中对普罗波的需求.
研究的目的:
- 评估选择性通风活供体肝移植 (LDLT) 接受者的镇静所需的普罗波福尔剂量.
- 为了比较实际的propofol剂量与用于镇静的常规剂量.
- 评估在LDLT后的ICU环境中调整的propofol剂量的安全性和有效性.
主要方法:
- 在LDLT后的ICU患者中,以1mg.kg-1.h-1开始的propofol输液.
- 剂量定位以保持双光谱指数 (BIS) 的60-80.
- 没有同时使用其他镇静剂 (阿片类药物,二类药物);监测普罗波福,诺拉德林和乳酸盐水平.
主要成果:
- 平均需要的普罗波福尔剂量为1.02 ± 0.26 mg.kg-1.h-1,明显低于标准剂量.
- 在ICU转移后的14小时内,诺拉丁上腺素被断奶.
- 在停止使用普罗波后大约2小时内发生了输出.
- 没有发现propofol剂量与乳酸,氨或移植与受体重量比率之间的相关性.
结论:
- 在LDLT接受者中,用于术后镇静的普罗波所需剂量范围低于常规剂量.
- 在LDLT后的手术后期,较低的普罗波福尔剂量可能足以用于镇静.
- 这一发现支持在肝移植接受者中进行个性化位的普罗波.
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