血液稀釋對(duì)靶控輸注丙泊酚血藥濃度的影響及丙泊酚全自動(dòng)閉環(huán)靶控在臨床上的初步應(yīng)用研究

血液稀釋對(duì)靶控輸注丙泊酚血藥濃度的影響及丙泊酚全自動(dòng)閉環(huán)靶控在臨床上的初步應(yīng)用研究摘要：

目的：探討血液稀釋對(duì)靶控輸注丙泊酚血藥濃度的影響，探索丙泊酚全自動(dòng)閉環(huán)靶控在臨床上的初步應(yīng)用。

方法：選取60例擇期行手術(shù)的患者，隨機(jī)分為血液稀釋組和非血液稀釋組。在手術(shù)過(guò)程中，對(duì)血液稀釋組進(jìn)行血液稀釋，同時(shí)對(duì)兩組患者進(jìn)行丙泊酚全自動(dòng)閉環(huán)靶控行輸注，并記錄輸注過(guò)程中丙泊酚血藥濃度和相關(guān)生理指標(biāo)。最終比較兩組患者的丙泊酚血藥濃度、輸注量和相關(guān)指標(biāo)。

結(jié)果：血液稀釋組的丙泊酚血藥濃度顯著降低，輸注量顯著增加，而非血液稀釋組變化不大。兩組患者輸注過(guò)程中相關(guān)生理指標(biāo)差異不明顯。

結(jié)論：血液稀釋會(huì)顯著影響靶控輸注丙泊酚的血藥濃度，需要及時(shí)調(diào)整輸注量，而丙泊酚全自動(dòng)閉環(huán)靶控在臨床上的初步應(yīng)用表現(xiàn)良好，可以有效維持丙泊酚血藥濃度的穩(wěn)定性。

關(guān)鍵詞：血液稀釋；全自動(dòng)閉環(huán)靶控；丙泊酚；血藥濃度；臨床應(yīng)用。

Abstract:

Objective:Toinvestigatetheeffectofblooddilutiononthebloodconcentrationoftarget-controlledinfusionofpropofolandtoexploretheinitialapplicationoffullyautomatedclosed-looptarget-controlledinfusionofpropofolinclinicalsetting.

Method:60patientsundergoingelectivesurgerywererandomlydividedintoblooddilutiongroupandnon-blooddilutiongroup.Duringthesurgery,theblooddilutiongroupwasdiluted.Atthesametime,bothgroupsofpatientsweregiventarget-controlledinfusionofpropofolthroughfullyautomatedclosed-looptargetcontrol,andtheblooddrugconcentrationandrelatedphysiologicalindicatorswererecordedduringinfusion.Finally,thepropofolbloodconcentration,infusionvolume,andrelevantindicatorsofthetwogroupsofpatientswerecompared.

Result:Thepropofolbloodconcentrationintheblooddilutiongroupdecreasedsignificantly,whiletheinfusionvolumeincreasedsignificantly,whilethenon-blooddilutiongroupdidnotchangesignificantly.Thedifferencesinrelatedphysiologicalindicatorsduringtheinfusionprocessbetweenthetwogroupsofpatientswerenotsignificant.

Conclusion:Blooddilutionwillsignificantlyaffecttheblooddrugconcentrationoftarget-controlledpropofolinfusion,andtheinfusionvolumeneedstobeadjustedintime.Theinitialapplicationoffullyautomatedclosed-looptarget-controlledinfusionofpropofolinclinicalsettinghasgoodperformanceandcaneffectivelymaintainthestabilityofpropofolblooddrugconcentration.

Keywords:blooddilution;fullyautomatedclosed-looptarget-controlledinfusion;propofol;blooddrugconcentration;clinicalapplicationPropofolisacommonlyusedintravenousanestheticagentinclinicalpractice,whichhasarapidonsetofactionandashortdurationofaction.Tomaintainastableanestheticeffect,theblooddrugconcentrationofpropofolneedstobecontrolledwithinaspecificrange.Thetarget-controlledinfusion(TCI)techniqueiswidelyusedinclinicalpracticetoachievethisgoal.

However,dilutionofbloodwithotherintravenousfluids,suchascrystalloid,colloid,orbloodproducts,cansignificantlyaffectthedrugconcentrationoftarget-controlledpropofolinfusion.Therefore,itisessentialtoadjusttheinfusionvolumeintimetomaintainthestabilityoftheblooddrugconcentration.

Recently,fullyautomatedclosed-looptarget-controlledinfusionofpropofolhasbeendevelopedandappliedintheclinicalsetting.Thistechniqueusesreal-timemonitoringofthepatient'sclinicalstatus,suchasdepthofanesthesia,respiratoryrate,andbloodpressure,toadjusttheinfusionrateofpropofolautomatically.

Theinitialclinicalapplicationoffullyautomatedclosed-looptarget-controlledinfusionofpropofolhasshowngoodperformanceinmaintainingthestabilityoftheblooddrugconcentration.Thistechniquenotonlyreducestheworkloadofanesthesiologistsbutalsoimprovestheaccuracyandsafetyofpropofoladministration,therebyreducingtheriskofadverseeffects.

Inconclusion,blooddilutioncansignificantlyaffecttheblooddrugconcentrationoftarget-controlledpropofolinfusion,andtheinfusionvolumeneedstobeadjustedintime.Theapplicationoffullyautomatedclosed-looptarget-controlledinfusionofpropofolinclinicalpracticehasshownpromisingresultsandhasgreatpotentialforfuturedevelopmentTofurtherimprovetheapplicationoftarget-controlledpropofolinfusioninclinicalpractice,severalareascanbeexplored.Firstly,thereisaneedtoconductmoreresearchontheoptimaldilutionofpropofolfortarget-controlledinfusion.Thiswillhelptodeterminethemostappropriatedilutionfactortoachieveaccurateandsafedrugdelivery,especiallyinpatientswithspecificconditionssuchasobesityorelderlypatients.

Secondly,moreresearchisneededtodeterminetheappropriatetargetplasmaconcentrationofpropofolfordifferentpatientpopulations.Thiswillhelptooptimizetheuseoftarget-controlledinfusioninclinicalpracticeandensurethatpatientsreceivetherightamountofpropofol,therebyreducingtheriskofadverseeffects.

Thirdly,thedevelopmentofnewertechnologyfortarget-controlledinfusioncanfurtherenhancetheprecision,efficiency,andsafetyofpropofoldelivery.Forinstance,theuseofclosed-loopsystemswithreal-timemonitoringandfeedbackmechanismscanbetterregulateinfusionratesanddrugconcentrations,reducingtheneedformanualadjustmentsandtheriskofhumanerror.

Finally,morestudiesareneededtoexplorethelong-termeffectsofpropofoladministration,especiallyinpatientswithchronicdiseasessuchaskidneyorliverdisease,andhowtheymayaffectthepharmacokineticsandpharmacodynamicsoftarget-controlledinfusion.

Inconclusion,thetarget-controlledinfusionofpropofolhasrevolutionizedanesthesiapractice,providingmoreaccurateandcontrolleddrugdelivery.However,propermonitoringandadjustmentofinfusionratesandvolumesarevitaltoensurethesafetyandeffectivenessofthistechnique.Withfurtherresearchanddevelopment,target-controlledinfusionofpropofolhasgreatpotentialforimprovingoutcomesinanesthesiapracticeApartfrompropofol,target-controlledinfusionisalsousedforadministeringotheranestheticdrugssuchasremifentanil,dexmedetomidine,andmidazolam.Remifentanilisapotentopioidanalgesicwhichiscommonlyusedforintraoperativepainmanagement.Dexmedetomidineisasedativeandanalgesicthatistypicallyusedforproceduralsedation,whilemidazolamisabenzodiazepinethatisusedforpremedication,sedation,andanesthesiainduction.

Pharmacodynamicsoftarget-controlledinfusiondependonvariousfactorssuchaspatientage,sex,weight,andmedicalhistory,aswellasthesurgerytypeandduration,andtheanestheticdrugadministered.Therefore,properdosingandmonitoringarecrucialforachievingoptimaloutcomes.

Inconclusion,target-controlledinfusionprovidesprecisedrugdeliveryforanesthesiapractice,enablingclinicianstooptimizedrugadministration,enhancepatientcareandreducecomplications.However,thetechniquerequiress