施奈德和埃利维尔德对普罗波福向控制输液麻醉的模型:临床比较
Federico Linassi1,2, Paolo Zanatta2, Leonardo Spano3
1Department of Pharmaceutical and Pharmacological Sciences, Università Degli Studi di Padova, Via Marzolo 5, 35131 Padova, Italy.
Life (Basel, Switzerland)
|October 28, 2023
概括
与施奈德模型相比,埃莱维尔德针对普罗波的目标控制输注 (TCI) 的药理动力学/药理动力学 (PK/PD) 模型显示出不同的效果部位度. 埃莱维尔德模型导致麻醉事件的加深和爆发抑制的频率更高,特别是在老年患者中.
科学领域:
- 麻醉学 麻醉学
- 药理动力学和药理动力学
- 临床药理学 临床药理学
背景情况:
- 存在各种各样的药理动力学/药理动力学 (PK/PD) 模型,用于在完全静脉注射麻醉中对目标控制输液 (TIVA-TCI) 进行普罗波的剂量.
- 为了优化TIVA-TCI,比较已建立的 (Schnider) 和较新的 (Eleveld) PK/PD模型的性能至关重要.
- 准确的propofol剂量确保了患者的安全和麻醉疗效.
研究的目的:
- 在临床上比较施奈德PK/PD模型和EleveldPK/PD模型在TIVA-TCI期间的性能.
- 评估每个模型对麻醉深度和患者反应的影响.
- 评估两种模型之间的麻醉事件的差异,特别是老年患者.
主要方法:
- 一项前性观察性研究招募了78名接受乳腺手术的女性患者 (37名成年人,41名老年人).
- 在没有神经肌肉阻塞的情况下,TIVA-TCI以双光谱指数 (BIS) 和外科整形指数 (SPI) 为指导.
- 进行比较的关键参数包括不同响应状态的propofol效应部位度 (CeP),持续时间指标和麻醉事件 (DAE,BSE,LAE,USRE).
主要成果:
- 与施奈德模型相比,Eleveld模型在响应能力丧失时显示较低的CeP,在维护和响应能力恢复期间显示较高的CeP (p < 0.001).
- 麻醉性歇斯底里斯仅在施奈德模型中观察到 (p < 0.001).
- 在Eleveld模型中,麻醉事件的加深 (DAE) 和爆发抑制事件 (BSE) 在一般人群和老年人亚组 (p <0.05) 显着更频繁.
结论:
- 施奈德和埃莱维尔德的PK/PD模型在TIVA-TCI期间显著影响醇效应部位度 (CePs).
- 随着Eleveld模型的DAE和BSE发病率增加,特别是在老年患者中,需要仔细考虑并可能调整剂量策略.
- 可能需要进一步的研究来完善针对特定患者群体的Eleveld模型参数,以提高安全性和有效性.
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