The changes in the difference between the target and measured plasma concentrations of propofol given by target-controlled infusion during the three phases of orthotopic liver transplantation / 中华麻醉学杂志

ABSTRACT

Objective To examine the changes in the difference between the target and actually measured plasma concentrations of propofol administered by target-controlled infusion (TCI) during the three phases (preanhepatic, anhepatic, neohepatic) of orthotopic liver transplantation. Methods Ten ASA Ⅲ-Ⅳ patients aged 30-54 yr, weighing 56-79 kg undergoing orthotopic liver transplantation were enrolled in the study. The patients were unpremedicated. Radial artery was cannulatecl and Swan-Ganz catheter was placed via right internal jugular vein. BP, ECG, SpO2 , PCT CO2, PAP, PCWP, body temperature and blood gases, electrolytes and glucose were monitored during operation. Anesthesia was induced with scopolamine 0.6 mg, midazolam 0.05 mg ? kg , etomidate 0.2 mg ? kg-1 , fentanyl 5 ?g ? kg-1 and rocuronium 0.6 mg ? kg -1 . Propofol was given with the TCI system after induction. Target plasma propofol concentration was set at 0.5 ?g ? ml -1 which was maintained during operation. Arterial blood samples were taken after equilibrium between plasma and effect site concentrations had been reached and during the three phases of orthotopic liver transplantation. Plasma propofol concentration was measured by high-performance liquid chromatography with fluorescence detection. Results One patient was excluded from data analysis because TCI propofol was stopped during operation. The average measured plasma propofol concentration in the nine patients were significantly higher during anhepatic phase than those during preanhepatic and neohepatic phases ( P