Study On Pharmacokinetics And Effective Evaluation Of Propofol TCI Total Intravenous Anesthesia And Combination With Sevoflurane Inhalational Anaesthesia

Objective:Propofol TCI is a new intravenous anesthetic drug.It has many advantages such as inducing anesthesia rapidly and smoothy,no saving.Meanwhile, it also had some adverse effects such as curbing circulatory system and respiratory system.Sevoflurane is a new type of inhalational anesthetic drug,its advantages were lower blood/gas distribution,inducing anesthesia rapidly and awaking rapidly.In our study,we will compare the pharmacokinetic parameters of propofol from the peripheral veins,and compare the effects of propofol TCI/Sevoflurane inhalation and only propofol TCI,on the hemodynimics,awake time and postoperative recovery in patients.Methods:We validated the following test methods,TIANHE Kromasil C₁₈ was packed in the analytical column,The mobile phase consisted of acetonitrile:methanol:water(10:60:30),UV detection wavelength was 273 nm to detect serum samples.To choose fifteen ASAâ… -â…¢patients scheduled for different surgical procedure were randomized into Propofol TCI anesthesia/Sevoflurane inhalational anesthesia group(Sev group)and Propofol TCI(Pro group).In Sev group, Propofol TCI was maintained after intubation with the target concentration at 3.5μg/ml and Sevoflurane(end-tidal concentration of 1.5-2%)was inhaled,in Pro group Propofol TCI was maintained after intubation with the target concentration at 3.5μg/ml.Sufentanil and Rocuronium Bromide were intravenously infused according to the depth of anesthesia during the operation.MAP and HR were measured before induce,skin incision after intubation,maintenance,stop drug and awake.Awake time, PONV of the patients were observed after operation.Results:Propofol was extracted well from other components in serum,the mean recovery of propofol was 96.72%, the relative standard deviation(RSD)of within day and between day was all less than 10%.The main pharmacokinetics parameters of propofol V_d 6.625±4.176L/kg,V_c 0.859±0.305L/kg,V_p 6.315±4.434L/kg,CL_s 51.78±16.24ml/kg/min,t_1/2α1.14±0.82min,t_1/2β44.10±29.14min,In Sev group,V_d 7.595±5.379L/kg,V_c 0.788±0.006L/kg,V_p 5.05±3.07L/kg,CL_s 40.2±15.8ml/kg/min,t_1/2α2.15±0.35min, t_4/2β30.41±27.51min.the mean concentration of propofol in serum was 1.46±0.89μg/ml.No significant difference in MAP and HR between Sev group and Pro group(p＞0.05),there was significant difference in MAP and HR at skin incision after intubation(p＜0.05).No significant difference was also found in the awake time between the two groups(p＞0.05),and there was no significant difference in the incidence of PONV,headache,agitation(p＞0.05).Conclusion:The method was found to be simple and accurate,the experiment supplied reference methods for determination of concentration of propofol in serum.The pharmacokinetics of propofol from the peripheral veins was fitted to two-compartment open model. Propofol TCI/Sevoflurane inhalational anesthesia and Propofol TCI anesthesia are all effective in inducing good anesthetic effect.maintaining hemodynamic stability and ensuring rapid recovery.and the lower of the incidence of PONV in operations.