丙泊酚及靶控输注系统课件.ppt

Conscious/Unconscious Prediction (Pk)(意识清楚/无意识的预测) Glass et al, Anesthesiology 86:836-847, 1997 Agent (n) BIS Target 浓度 Measured 丙泊酚 (399) 0.976* 0.936 0.937 异氟醚(70) 0.959 0.965 0.967 咪唑安定 (50) 0.885 0.859 0.886 Significantly different from Pk value for Target Concentration (p 0.001), and Measured concentration (p 0.01) 浓度 Are drug models predictive?(药物模型有预测性吗?) Mathematical models of drug behavior incorporating effect site concentrations and drug interactions predict anesthetic drug effect (e.g., loss of response to stimulation) as well as:(结合了效应部位浓度和药物相互作用的药物行为学数学模型可以用来预测药物的效应(例如, 对刺激反应的丧失)，如同下列指标: Measured concentrations BIS AAI（Auditory Evoked Potential） Third Generation TCI靶控输注系统Closed Loop Effect Site Control(闭合回路 效应部位 控制) RUGLOOP (De Smet, Struys,Ghent) Closed Loop Control of Propofol(闭合回路控制丙泊酚) Struys et al, Anesthesiology. 95:6-17, 2001 BIS Systolic Heart Rate closed-loop control classic-control 闭合回路控制 标准控制 Over 500 peer-reviewed articles in Medline as of September 2006(至2006 年9月，Medline有超过500篇相关的同行评论文章)Approved everywhere except in the US(除美国以外均可使用) 全世界应用靶控输注系统 UK IRELAND BELGIUM FRANCE NORWAY SWEDEN DENMARK NETHERLANDS GERMANY AUSTRIA BRAZIL CHILE PERU COLUMBIA MEXICO VENEZUELA ARGENTINA SPAIN PORTUGAL ITALYCANADA PHILLIPINES HONG KONG SINGAPORE AUSTRALIA NEW ZEALAND POLAND HUNGARY BULGARIA JAPAN CHINA 世界使用靶控输注系统 药量指南 丙泊酚/瑞芬太尼 TIVA 丙泊酚 3-5 ?g/ml 瑞芬太尼 2-6 ng/ml TIVAN 氧化亚氮: 65-70% 丙泊酚 at 2.5-3.5 ?g/ml 瑞芬太尼 at 2-6 ng/ml Thank You Professor Shuren Li President, Chinese Society of Anesthesiologists Professor Yun Yue Professor and Chairman, Beijing Chaoyang Hospital Dr. Yuguang Huang Scientific Director, Chinese Language Edition, Anesthesia Analgesia Edith Huang AstraZeneca Pharmaceutical Co., Ltd. Dr. Xi Hong Translator of slides and presentation Laura Freyberg Neighbor, dear friend, and translation assistance in US 谢谢 * * TCI and Propofol(丙泊酚及靶控输注系统) Steven Shafer (史蒂文宪佛) Editor-in