【摘要】 目的 评价 Diprifusor-靶控输注（TCI）系统的临床执行情况。方法 择期行腹部手术的患者27例，使用 Diprifusor-TCI 系统 Graseby 3500泵异丙酚 TCI，采用高效液相色谱荧光法检测血浆异丙酚浓度；采用执行误差（PE）的中位数（MDPE）、PE 绝对中位数（MDAPE）、分散度和摆动度作为评价执行情况的指标。结果 MDPE、MDAPE、分散度和摆动度的中位数（最小值～最大值）分别为14.9%（-21.6%～42.9%），23.3%（6.9%～62.5%），-1.9%·h^-1(-32.7%·h^-1～23.0%·h^-1)和18.9%（4.2%～59.6%）。PE 不随用药时间的改变而增加，但随着靶浓度的增加而增加。结论 所有患者术中麻醉效果满意，系统的偏离性较小，精密度较高且分散度小，但系统的 Wobble 偏大。此输注系统的药物动力学参数用于中国人需要进一步优化。更多还原

【Abstract】 Objective The pharmacokinetic parameters incorporated in the dipritusor TCI system aresomewhat different from those measured in Chinese.The purpose of this study was to assess the predictiveperformance of Diprifusor TCI system in Chinese,Methods Twenty-seven ASA Ⅰ-Ⅱ patients scheduled forelective abdominal surgery under general anesthesia were enrolled in this study.Premedication consisted ofintramuscular phenobarbital 0.1g anti scopolamine 0.3 mg.Radial artery was cannulated for BP monitoring andblood sampling.BIS,AEP,EGG,MAP,HR,P_ET CO₂ and SpO₂ were continuously monitored during theexperiment.A loading dose of fentanyl 3 μg·kg^-1 was given i.v.followed by continuous infusion at 2 μg·kg^-1·h^-1 for 30 min.The infusion rate was then reduced to 1.5 μg·kg^-1·h^-1 for 150 min then to 1.0 μg·kg^-1·h^-1until 30 min before the end of surgery.Propofol was infused by Diprifusor TCI system.The target plasmaconcentration was set at 3-4 μg·ml^-1.Blood samples were taken before propofol infusion,2 min after induction ofanesthesia,3 min after every increase in target plasma concentration>25% or decrease by 15%,at termination ofTCI propofol and 5 rain after termination for determination of arterial plasma propofol concentrations which werecompared with the values predicted by the TCI system.Performance was determined by the median performanceerror（MDPE）,the mean absolute performance error（MDAPE）,the divergence and the wobble.Results A totalof 200 blood samples were taken.The mean value for MDPE was 14.9%（-21.6%-42.9%）,for MDAPE23.3%（6.9%-62.5%）,for divergence -1.9%·h^-1(-32.7%·h^-1-23.0%·h^-1)and for wobble 18.9%（4.2%-59.6%）.PE did not increase with time but with increasing target propofol concentration.ConclusionThe anesthesia was satisfactory in all patients.The predictive performance of Diprifusor TCI system is consideredacceptable for clinical purposes.The wobble is relatively big,for Chinese patients the pharmacokinetic model needsimproving.更多还原