PDF(Pubmed)
Abstract：
BACKGROUND: The incidence of arterial hypotension during induction of general anesthesia is influenced by the method of propofol administration, but there is a dearth of randomized clinical trials comparing bolus injection and target-controlled infusion in relation to arterial hypotension. This study seeks to compare the incidence of arterial hypotension between these two methods of propofol administration.
METHODS: This prospective, randomized, single-center, non-blinded study included 60 patients (aged 35 to 55 years), classified as ASA physical status I or II, who were undergoing non-cardiac surgeries. They were randomly allocated using a computer to two groups based on the method of propofol administration during the induction of general anesthesia: the Target Group, receiving target-controlled infusion at 4 μg.mL-1, and the Bolus Group, receiving a bolus infusion of 2 mg.kg-1. Both groups also received midazolam 2 mg, fentanyl 3 μg.kg-1, and rocuronium 0.6 mg.kg-1. Over the first 10 minutes of anesthesia induction, Mean Arterial Pressure (MAP), Heart Rate (HR), level of Consciousness (qCON), and Suppression Rate (SR) were recorded every 2 minutes.
RESULTS: Twenty-seven patients remained in the TCI group, while 28 were in the Bolus group. Repeated measure analysis using mixed-effects models could not reject the null hypothesis for the effect of group-time interactions in MAP (p = 0.85), HR (p = 0.49), SR (p = 0.44), or qCON (p = 0.72). The difference in means for qCON (60.2 for TCI, 50.5 for bolus, p < 0.001), MAP (90.3 for TCI, 86.2 for bolus, p < 0.006), HR (76.2 for TCI, 76.9 for bolus, p = 0.93), and SR (0.01 for TCI, 5.5 for bolus, p < 0.001), irrespective of time (whole period means), revealed some significant differences.
CONCLUSIONS: Patients who received propofol bolus injection exhibited a lower mean arterial pressure, a greater variation in the level of consciousness, and a higher suppression rate compared to those who received it as a target-controlled infusion. However, the interaction effect between groups and time remains inconclusive.
METHODS: This prospective, randomized, single-center, non-blinded study included 60 patients (aged 35 to 55 years), classified as ASA physical status I or II, who were undergoing non-cardiac surgeries. They were randomly allocated using a computer to two groups based on the method of propofol administration during the induction of general anesthesia: the Target Group, receiving target-controlled infusion at 4 μg.mL-1, and the Bolus Group, receiving a bolus infusion of 2 mg.kg-1. Both groups also received midazolam 2 mg, fentanyl 3 μg.kg-1, and rocuronium 0.6 mg.kg-1. Over the first 10 minutes of anesthesia induction, Mean Arterial Pressure (MAP), Heart Rate (HR), level of Consciousness (qCON), and Suppression Rate (SR) were recorded every 2 minutes.
RESULTS: Twenty-seven patients remained in the TCI group, while 28 were in the Bolus group. Repeated measure analysis using mixed-effects models could not reject the null hypothesis for the effect of group-time interactions in MAP (p = 0.85), HR (p = 0.49), SR (p = 0.44), or qCON (p = 0.72). The difference in means for qCON (60.2 for TCI, 50.5 for bolus, p < 0.001), MAP (90.3 for TCI, 86.2 for bolus, p < 0.006), HR (76.2 for TCI, 76.9 for bolus, p = 0.93), and SR (0.01 for TCI, 5.5 for bolus, p < 0.001), irrespective of time (whole period means), revealed some significant differences.
CONCLUSIONS: Patients who received propofol bolus injection exhibited a lower mean arterial pressure, a greater variation in the level of consciousness, and a higher suppression rate compared to those who received it as a target-controlled infusion. However, the interaction effect between groups and time remains inconclusive.
摘要：
背景：全身麻醉诱导期间动脉低血压的发生率受丙泊酚给药方法的影响，但缺乏比较推注和靶控输注与动脉低血压的关系的随机临床试验.这项研究旨在比较这两种异丙酚给药方法之间动脉低血压的发生率。
方法：这种前瞻性，随机化，单中心,非盲研究包括60名患者（年龄35至55岁），归类为ASA的身体状态I或II，正在接受非心脏手术的人。根据全麻诱导期间丙泊酚给药的方法，使用计算机将其随机分为两组：目标组，接受4μg的靶控输注。mL-1和Bolus组，接受推注2毫克。kg-1.两组还接受咪达唑仑2mg，芬太尼3μg。kg-1和罗库溴铵0.6mg。kg-1.在麻醉诱导的前10分钟，平均动脉压(MAP),心率(HR)意识水平（qCON），每2分钟记录一次抑制率(SR)。
结果：TCI组仍有27名患者，而28人在博鲁斯组。使用混合效应模型的重复测量分析不能拒绝MAP中群体时间相互作用效应的零假设(p=0.85)，HR（p=0.49），SR（p=0.44），或qCON(p=0.72)。qCON的平均值差异(TCI为60.2，推注为50.5，p<0.001)，MAP（TCI为90.3，推注为86.2，p<0.006),HR（TCI为76.2，推注为76.9，p=0.93),和SR(TCI为0.01，推注为5.5，p<0.001)，不论时间(wholeperiodmeans)，揭示了一些显著的差异。
结论：接受丙泊酚推注的患者表现出较低的平均动脉压，意识水平的更大变化，与作为目标控制输注的患者相比，抑制率更高。然而,群体与时间之间的相互作用效应尚无定论。
方法：这种前瞻性，随机化，单中心,非盲研究包括60名患者（年龄35至55岁），归类为ASA的身体状态I或II，正在接受非心脏手术的人。根据全麻诱导期间丙泊酚给药的方法，使用计算机将其随机分为两组：目标组，接受4μg的靶控输注。mL-1和Bolus组，接受推注2毫克。kg-1.两组还接受咪达唑仑2mg，芬太尼3μg。kg-1和罗库溴铵0.6mg。kg-1.在麻醉诱导的前10分钟，平均动脉压(MAP),心率(HR)意识水平（qCON），每2分钟记录一次抑制率(SR)。
结果：TCI组仍有27名患者，而28人在博鲁斯组。使用混合效应模型的重复测量分析不能拒绝MAP中群体时间相互作用效应的零假设(p=0.85)，HR（p=0.49），SR（p=0.44），或qCON(p=0.72)。qCON的平均值差异(TCI为60.2，推注为50.5，p<0.001)，MAP（TCI为90.3，推注为86.2，p<0.006),HR（TCI为76.2，推注为76.9，p=0.93),和SR(TCI为0.01，推注为5.5，p<0.001)，不论时间(wholeperiodmeans)，揭示了一些显著的差异。
结论：接受丙泊酚推注的患者表现出较低的平均动脉压，意识水平的更大变化，与作为目标控制输注的患者相比，抑制率更高。然而,群体与时间之间的相互作用效应尚无定论。
