Pharmacokinetics and pharmacodynamics of propofol in patients undergoing abdominal aortic surgery

Available propofol pharmacokinetic protocols for target-controlled infusion (TCI) were obtained from healthy individuals. However, the disposition as well as the response to a given drug may be altered in clinical conditions. The aim of the study was to examine population pharmacokinetics (PK) and pharmacodynamics (PD) of propofol during total intravenous anesthesia (propofol/fentanyl) monitored by bispectral index (BIS) in patients scheduled for abdominal aortic surgery. Population nonlinear mixed-effect modeling was done with Nonmem. Data were obtained from ten male patients. The TCI system (Diprifusor) was used to administer propofol. The BIS index served to monitor the depth of anesthesia. The propofol dosing was adjusted to keep BIS level between 40 and 60. A two-compartment model was used to describe propofol PK. The typical values of the central and peripheral volume of distribution, and the metabolic and inter-compartmental clearance were V(C) = 24.7 l, V(T) = 112 l, Cl = 2.64 l/min and Q = 0.989 l/min. Delay of the anesthetic effect, with respect to plasma concentrations, was described by the effect compartment with the rate constant for the distribution to the effector compartment equal to 0.240 min(-1). The BIS index was linked to the effect site concentrations through a sigmoidal E(max) model with EC(50) = 2.19 mg/l. The body weight, age, blood pressure and gender were not identified as statistically significant covariates for all PK/PD parameters. The population PK/PD model was successfully developed to describe the time course and variability of propofol concentration and BIS index in patients undergoing surgery.     

Pharmacokinetics and pharmacodynamics of propofol in children undergoing different types of surgeries

BackgroundPropofol is a commonly used agent in total intravenous anesthesia (TIVA). However, the link between its pharmacokinetics and pharmacodynamics has not been fully characterized in children yet. Our aim was to determine the quantitative relationship between the venous plasma concentration and bispectral index (BIS) effect in a heterogeneous group of pediatric patients undergoing various surgical procedures (ASA status I–III).MethodsNine male and nine female patients were anesthetized with propofol–fentanyl TIVA. Sparse venous samples for propofol concentrations assay and dense BIS measurements were collected during and after the end of infusion. Nonlinear mixed-effect modeling in NONMEM was used for data analysis.ResultsA three-compartment model was linked with a classical E_max model through a biophase compartment to describe the available data. All clearance and volume terms were allometrically scaled to account for the body mass difference among the patients under study. A typical patient had their PK parameters observed within the range of literature values for children. The pharmacodynamic parameters were highly variable. The EC₅₀ of 2.80 mg/L and the biophase distribution rate constant of 3.33 min⁻¹ were found for a typical patient.ConclusionsThe BIS values in children are highly correlated with the propofol effect compartment concentrations according to the classical E_max concentration–response relationship. Children had slightly lower sensitivity to propofol and slightly higher clearance, as compared with the adult data available in literature. The intra-patient variations in the BIS require the anesthesiologist's attention in using BIS values alone to evaluate the depth of anesthesia in children.     

Influence of demographic factors, basic blood test parameters and opioid type on propofol pharmacokinetics and pharmacodynamics in ASA I-III patients

The aim of the study was to examine population pharmacokinetics (PK) and pharmacodynamics (PD) of propofol (CAS 2078-54-8) during total intravenous anesthesia monitored by spectral frequency index (SFx). Twenty-eight patients of ASA physical status I-III (ASA: American Society of Anesthesiologists) scheduled for laparoscopic cholecystectomy were included. In group I an anesthesia was induced with a bolus of propofol (2 mg/kg) and remifentanil (CAS 132875-61-7) (1.0 microg/kg), followed by a continuous infusion of remifentanil. In group II, an alfentanil (CAS 71195-58-9) (10 microg/kg) bolus dose was followed by a continuous infusion of alfentanil. The general anesthetic technique included propofol, opioid and muscle relaxant. During anesthesia, the propofol infusion rate (3-8 mg/kg/h) was adjusted to the SFx value. Venous blood samples were collected from the patients during 240 min after termination of the infusion. A two compartment model was used to describe propofol PK. A standard effect compartment model was used to describe the delay between the effect and the concentration of propofol. The SFx index was linked to the effect site concentrations through a sigmoidal Emax model. The influence of continuous (body weight, age, blood pressure, heart rate and blood oxygenation, serum protein, the erythrocyte count, hemoglobin and hematocrit, serum creatinine and creatinine clearance) and categorical (gender and the type of opioid) covariates on the pharmacokinetic and pharmacodynamic parameters was investigated. PK/PD analysis was performed using NONMEM. All the screened covariates did not influence propofol PK and PD, except of the opioid type. The central compartment volume of propofol was larger in the presence of remifentanil than in the presence of alfentanil.     

Evidence of Different Propofol Pharmacokinetics under Short and Prolonged Infusion Times in Rabbits

Propofol is an anaesthetic widely used in both human beings and animals. However, the characterization of propofol pharmacokinetics (PK) is not well understood when long‐term infusions are used. The main objective of this study was to explore the PK behaviour of propofol in a rabbit model during short and prolonged propofol infusions and to develop an internally validated PK model, for propofol dose individualization in the rabbit for future use. Population 1 (P1) was constituted by seven New Zealand rabbits and was used to characterize the PK profile of propofol at short infusions. Animals were anaesthetized with a bolus of 20 mg/kg, followed by an infusion rate of 50 mg/kg/hr of propofol at 1%, which was then maintained for 30 min. A second rabbit population (P2, n = 7) was sedated according to reflexes responses and Index of Consciousness values, for 20 consecutive hours using propofol 2% aiming at characterizing propofol behaviour at long‐term infusions. Clinical data and blood samples were collected at specific time‐points in both populations. Propofol plasma concentrations were determined by gas chromatography/ion trap mass spectrometry. The NONMEM VII software was used to evaluate the relationships between dose and plasma concentrations. A linear two‐compartment model with different central compartment volume and plasma clearance (separately modelled in the two populations) was the one that best described propofol concentrations. The time course of propofol plasma concentrations was well characterized by the PK model developed, which simultaneously accounts for propofol short‐ and long‐term infusions and can be used to optimize future PK studies in rabbits.     

The pharmacokinetics of propofol in ICU patients undergoing long‐term sedation

The aim of this study was to characterize the pharmacokinetics (PK) of propofol in ICU patients undergoing long‐term sedation and to assess the influence of routinely collected covariates on the PK parameters. Propofol concentration–time profiles were collected from 29 patients. Non‐linear mixed‐effects modelling in NONMEM 7.2 was used to analyse the observed data. The propofol pharmacokinetics was best described with a three‐compartment disposition model. Non‐parametric bootstrap and a visual predictive check were used to evaluate the adequacy of the developed model to describe the observations. The typical value of the propofol clearance (1.46 l/min) approximated the hepatic blood flow. The volume of distribution at steady state was high and was equal to 955.1 l, which is consistent with other studies involving propofol in ICU patients. There was no statistically significant covariate relationship between PK parameters and opioid type, SOFA score on the day of admission, APACHE II, predicted death rate, reason for ICU admission (sepsis, trauma or surgery), gender, body weight, age, infusion duration and C‐reactive protein concentration. The population PK model was developed successfully to describe the time‐course of propofol concentration in ICU patients undergoing prolonged sedation. Despite a very heterogeneous group of patients, consistent PK profiles were observed. Copyright © 2016 John Wiley & Sons, Ltd.     

瑞芬太尼效应室靶控输注在结肠镜检查中的应用

目的比较复合丙泊酚静脉全麻时瑞芬太尼效应室靶控输注和芬太尼単次静脉注射用于结肠镜检查的麻醉效果。方法选择80例行结肠镜检查的患者,随机分为瑞芬太尼效应室靶控输注组（R组）和芬太尼单次静脉注射组（F组）,分别复合丙泊酚静脉注射行静脉全麻,观察起效时间、恢复时间、准确定向时间、术中体动（程度和次数）、呼吸抑制以及术后并发症等。结果 R组恢复时间显著短于F组（P〈0.01）,R组的丙泊酚总用量、术中最低SpO_2、术中体动及术后恶心呕吐、嗜睡显著低于F组（P〈0.01）。结论瑞芬太尼效应室靶控输注复合丙泊酚单次静脉注射的麻醉方法用于结肠镜检查,其临床效果优于芬太尼单次静脉注射复合丙泊酚的静脉麻醉,但需加强呼吸监护与管理。     

A two-compartment effect site model describes the bispectral index after different rates of propofol infusion

Different estimates of the rate constant for the effect site distribution (k_e0) of propofol, depending on the rate and duration of administration, have been reported. This analysis aimed at finding a more general pharmacodynamic model that could be used when the rate of administration is changed during the treatment. In a cross-over study, 21 healthy volunteers were randomised to receive a 1 min infusion of 2 mg/kg of propofol at one occasion, and a 1 min infusion of 2 mg/kg of propofol immediately followed by a 29 min infusion of 12 mg kg⁻¹ h⁻¹ of propofol at another occasion. Arterial plasma concentrations of propofol were collected up to 4 h after dosing, and BIS was collected before start of infusion and until the subjects were fully awake. The population pharmacokinetic-pharmacodynamic analysis was performed using NONMEM VI. A four-compartment PK model with time-dependent elimination and distribution described the arterial propofol concentrations, and was used as input to the pharmacodynamic model. A standard effect compartment model could not accurately describe the delay in the effects of propofol for both regimens, whereas a two-compartment effect site model significantly improved the predictions. The two-compartment effect site model included a central and a peripheral effect site compartment, possibly representing a distribution within the brain, where the decrease in BIS was linked to the central effect site compartment concentrations through a sigmoidal E_max model.     

瑞芬太尼复合丙泊酚靶控输注在小儿脑瘫手术中的应用

目的 评价瑞芬太尼复合丙泊酚全凭(TCT)静脉麻醉用于小儿脑瘫的临床效果.方法 选择择期需全麻下行肌力肌张力调整术或者行颈动脉剥脱术手术的患儿50例,随机分成A组和B组各25例.A组麻醉诱导(咪达唑仑0.2 mg/kg、丙泊酚1.0 mg/kg、瑞芬太尼1.5 μg/kg、琥珀胆碱2 mg/kg).麻醉维持连续靶控输注丙泊酚2~4 mg/(kg·h)微量持续泵注瑞芬太尼0.1~0.25 μg/(kg·min)能用肌松剂的维库溴胺0.03 μg/(kg·min)B组麻醉实施中麻醉诱导中瑞芬太尼改用芬太尼0.5~1 μg/kg麻醉维持中微量泵持续泵入瑞芬太尼改为间断推注芬太尼0.1 μg/(kg·min)其余药物使用方法及剂量同A组.结果 丙泊酚联合瑞芬太尼比丙泊酚联合芬太尼更能有效的控制麻醉诱导和手术过程中血压和心率的上升 并且使用瑞芬太尼组的患儿苏醒时间及拔管时间较使用芬太尼组明显缩短,术中丙泊酚的用量也大大减少.结论 丙泊酚联合瑞芬太尼适用于脑瘫患儿手术,且效果优于丙泊酚联合芬太尼.     

地佐辛复合丙泊酚在无痛人流中的临床应用

目的观察地佐辛复合丙泊酚用于无痛人流术的麻醉效果和安全性。方法选择我院门诊2012年3～10月收治的自愿要求终止妊娠的早孕妇女60例,均行无痛人流术。采用随机数字法分为两组：地佐辛组采用地佐辛＋丙泊酚麻醉,即丙泊酚复合地佐辛5mg;芬太尼组采用芬太尼＋丙泊酚麻醉,即丙泊酚复合芬太尼50ug。观察并比较两组患者的HR、SpO2、MAP、手术时间、清醒时间、丙泊酚用量及不良反应。结果两组患者麻醉效果满意,HR、SpO2、MAP、手术时间、清醒时间、丙泊酚用量及不良反应比较差异无统计学意义（P〉0．05）。结论地佐辛复合丙泊酚应用于无痛人流术麻醉安全可靠,镇痛效果满意,而且地佐辛复合丙泊酚麻醉术中呼吸抑制发生率、术后不良反应明显低于芬太尼复合丙泊酚麻醉,地佐辛复合丙泊酚麻醉恢复时问短于芬太尼复合丙泊酚麻醉恢复时间。     

丙泊酚靶控输注对老年患者全身麻醉血流动力学的影响

目的探讨丙泊酚不同用药方法对全身麻醉时老年患者血流动力学的影响。方法选取ASAI。II级择期行腹部手术老年患者40例,随机分为丙泊酚靶控输注（TcI）组与丙泊酚常规微泵恒速输注（P）组。麻醉过程中根据脑电双频指数（BIS）调整丙泊酚输注速度或靶浓度,分别记录麻醉诱导前（T0）、麻醉诱导后插管前（T。）、气管插管完成即刻（T2）、气管插管后5rain（＇r3）、切皮即刻（T4）、切皮后5min（＇r5）、气管拔管即刻（T6）两组患者相应的血流动力学参数,包括心率（HR）、收缩压（SBP）、舒张压（DBP）。同时记录各时刻BIS值、苏醒时间及术后不良反应发生率。结果与T0比较,TCI组在T2一T6各时点血流动力学指标波动较小（P〉0．05）;P组HR、SBP与DBP在T1时显著降低,T2与T6时显著升高（P〈0．05）。P组与TcI组比较,T2时SBP与DBP显著增高（P〈0．05）。TCI组患者术后睁眼、拔管时间及不良反应发生率均明显低于P组（P〈0．05）。结论靶控输注丙泊酚用于老年手术患者,血流动力学更加平稳,术后不良反应少。     

丙泊酚联合芬太尼用于无痛人工流产的麻醉效果观察

目的探讨丙泊酚联合芬太尼用于无痛人工流产中的麻醉效果。方法选取本院2009年1月～2011年1月自愿要求行无痛人工流产术的孕妇80例作为观察对象,全部患者随机分为A组和B组各40例。A组患者于术前30min肌注0.5mg阿托品,进手术室后取膀胱截石位,消毒和铺巾,建立静脉通路,并在给药前鼻导管吸氧以保持呼吸道畅通。然后缓慢静注2.0mg/kg丙泊酚和芬太尼0.05mg,达到镇静麻醉效果后,待睫毛反射消失时即可进行手术。B组患者静注2.0mg/kg丙泊酚后,待麻醉后即可开始手术。结果 A组的镇痛效果明显优于B组,差异有统计学意义（P〈0.05）。A组患者的丙泊酚用量明显少于B组,差异有统计学意义（P〈0.05）。A组无一例发生人工流产综合征及宫颈松弛,而A组术中及术后发生出血的例数也明显少于B组,差异有统计学意义（P〈0.05）。结论丙泊酚联合芬太尼用于无痛人工流产中的麻醉效果确切,镇痛效果明显,副反应少,麻醉诱导和苏醒加迅速,值得广泛推广和应用。     

靶控输注法对丙泊酚复合不同浓度芬太尼的临床观察

目的观察靶控输注丙泊酚和不同浓度芬太尼的临床效应。方法38例行下腹部手术的患者,随机分为2组,靶控输注丙泊酚3mg.mL-1分别复合芬太尼2ng.mL-1(A组)及4ng.mL-1(B组)。观察2组病人在麻醉前、气管插管后、切皮后的平均动脉压(MAP)、心率(HR)、心率变异性指数(LF/HF),并于气管插管后、切皮后、手术30,60,90及120min,观察2组病人的脑电双频指数(BIS)变化。结果A组病人在气管插管后,MAP、LF/HF均显著高于麻醉前;切皮后MAP、HR、LF/HF与麻醉前比较无显著性差异(P>0.05)。B组各指标在气管插管、切皮后与麻醉前比较,均无显著性差异(P>0.05)。2组各时间点的BIS值在35~58,组间比较无显著性差异。结论靶控输注丙泊酚3mg.mL-1伍用芬太尼4ng.mL-1,可以有效抑制气管插管和切皮反应,并可获得满意的麻醉深度;而伍用芬太尼2ng.mL-1可以有效抑制切皮反应,但不能抑制气管插管反应。     

BIS引导异丙酚镇静辅助椎管内麻醉在腹腔镜手术中的应用研究

目的探讨脑电双频指数（BIS）引导异丙酚靶控输注辅助椎管内麻醉行腹腔镜手术的可行性和优越性。方法选择腹腔镜手术患者60例,随机分为A、B组,每组30例。两组患者均行腰-硬联合麻醉并将麻醉平面控制在T6～T8水平,平面固定后先静脉注射芬太尼1μg/kg（10μg/ml）再以异丙酚镇静,A组在BIS监测下靶控输注异丙酚;B组异丙酚静脉注射负荷剂量后持续静脉泵注。观察两组麻醉前后生命体征的变化情况;比较两组异丙酚用量、手术时间、术后苏醒时间、输液量及不良反应发生情况。结果与B组比较,A组患者手术过程生命体征较稳定,无明显波动,不良反应少;异丙酚用量明显减少,术后苏醒较快（P〈0.05）。结论 BIS引导异丙酚靶控输注辅助椎管内麻醉行腹腔镜手术可精确调控麻醉深度并降低异丙酚用量,减少不良反应,是一种安全有效的麻醉方法。     

异丙酚对全麻术后病人恶心、呕吐的影响

目的 观察异丙酞预防术后恶心、呕吐的作用。方法 47例拟行选择性腹腔镜胆囊切除术病人被随机分为A组(24例)和B组(23例)。A组以芬太尼、异丙酞和万可松行麻醉诱导；B组以芬太尼、硫喷妥钠和万可松诱导。两组均以吸入异氟醚维持。观察两组病人的麻醉恢复特点和术后24h内恶心、呕吐发生率及应用镇吐药病人数。结果 两组病人术后唤醒时间、完全清醒时间及术后恶心、呕吐的发生率及应用镇吐药病人数相比较，A组各值均明显低于B组(P＜0．05)。结论 异丙酞行全身麻醉可有效地预防术后恶心、呕吐，并可显著缩短麻醉恢复时间。     

异丙酚复合地佐辛在宫腔镜手术麻醉中的疗效评价

目的评价异丙酚复合地佐辛用于宫腔镜手术麻醉的效果和安全性。方法拟在静脉全麻下行宫腔镜手术的患者90例,年龄25~60岁,体重45~65kg,ASA分级Ⅰ级或Ⅱ级。随机分为3组（各组n=30）：单纯异丙酚组（P组）,异丙酚复合0.001mg/kg芬太尼组（PF组）,异丙酚复合0.1mg/kg地佐辛组（PD组）。记录3组手术时间、异丙酚总用量、发生呼吸抑制的例数、出现体动的例数、麻醉苏醒时间,观察不良反应发生情况（头晕,恶心,呕吐）并询问术后有无宫缩痛。结果与P组比较,PD组和PF组异丙酚总用量减少（P〈0.05）,术中出现体动的例数减少（P〈0.05）,术后宫缩痛的发生率降低（P〈0.05）,与PF组比较,PD组呼吸抑制的发生率降低（P〈0.05）。结论异丙酚复合地佐辛用于宫腔镜手术麻醉效果确切,异丙酚用量减少,术中体动及术后宫缩痛的发生率降低,呼吸抑制较芬太尼轻,值得临床推广使用。     

两种静脉麻醉方式在无痛胃镜中的临床观察

目的比较丙泊酚分别联用芬太尼及咪唑安定在无痛胃镜检查中的有效性和安全性,寻求更安全有效的无痛胃镜麻醉方法。方法 160例要求行无痛胃镜检查的患者随机分为两组:A组80例,B组80例。A组为丙泊酚+芬太尼组,B组为丙泊酚+咪唑安定(力月西)组。A组先注射芬太尼0.5 mg后再注射丙泊酚1.5 mg/kg,B组先注射米唑安定0.03 mg/kg后再注射丙泊酚1.5 mg/kg,观察并记录患者用药前、用药后、插镜后、检查结束后各时间点的血压、心率、呼吸、血氧饱和度以及不良反应,记录患者的苏醒时间及麻醉药总量。结果两组都有令人满意的麻醉效果。结论与丙泊酚联合米唑安定相比,丙泊酚联合芬太尼麻醉效果更满意,不良反应更少,术后恢复更迅速,是更为理想的无痛内镜麻醉选择。     

Individual differences in pharmacokinetics and pharmacodynamics of anesthetic agent propofol with regard to CYP2B6 and UGT1A9 genotype and patient age

Propofol (2,6-diisopropylphenol) is administered intravenously for induction and maintenance of anesthesia; however, cases of progressive myocardial failure (propofol syndrome) related to the use of propofol have been reported. In the present study, the individual differences in pharmacokinetics and/or pharmacodynamics of propofol were investigated in patients who were genotyped for CYP2B6 and UGT1A9. Fifty-one patients treated with propofol in St. Marianna University Hospital were recruited for this study and provided written informed consent. The following parameters were analyzed: awakening time as a pharmacodynamic parameter, duration of propofol infusion, drug concentration in plasma after treatment, genotypes of CYP2B6 and UGT1A9, and age (42-84 years, mean of 65 years). Propofol was rapidly cleared from the blood of the subjects as a result of distribution and elimination. The awakening time after stopping propofol infusion was significantly correlated with the duration of infusion and the maximum concentration of propofol in these subjects. The maximum plasma concentration of propofol after normalizing with the duration of infusion was affected by the CYP2B6 G516T variant (related to impaired function) and was significantly affected by a propofol risk index score that incorporated CYP2B6 G516T and UGT1A9 I399C>T (high expression) genotypes and advanced age. These results provide important information indicating that the genotypes of the two enzymes studied and advanced age are combinative determinant factors of the pharmacokinetics and/or pharmacodynamics of propofol.     

Pharmacokinetic–Pharmacodynamic Modelling of Biomarker Response to Sitagliptin in Healthy Volunteers

Pharmacokinetic/pharmacodynamic (PK/PD) models can be useful tools in new drug development and also optimal drug therapy in patients. This study was designed to develop a PK/PD model of sitagliptin based on the physiology of incretin. The PK/PD data included information derived from two different studies. Study 1 was conducted as a one‐sequence, three‐period, repeated‐dose, dose escalation (sitagliptin 25, 50 and 100 mg q.d.) design in twelve healthy volunteers. Study 2 was a first‐in‐man study for the newly developed dipeptidyl peptidase‐4 (DPP‐4) inhibitor in healthy volunteers. In study 1, blood samples were collected to measure sitagliptin concentrations, DPP‐4 activity and active glucagon‐like peptide‐1 (GLP‐1) concentrations. In study 2, only data from the ‘placebo group’ were used, and blood samples were collected to measure DPP‐4 activity, active GLP‐1 concentrations and glucose concentrations. A PK/PD analysis was conducted using a non‐linear mixed effects modelling approach. Sitagliptin pharmacokinetics was modelled using a two‐compartment model with first‐order absorption. Changes in DPP‐4 inhibition were linked to the PK model using a sigmoid E_max model, whereas the active GLP‐1 changes were explained using an indirect response model; this model incorporated the glucose and DPP‐4 inhibition models. The PK/PD model developed adequately described the changes in sitagliptin concentration, DPP‐4 inhibition and active GLP‐1 concentration in healthy volunteers.     

丙泊酚联合芬太尼在门诊无痛人工流产术中的应用

目的 探讨丙泊酚复合芬太尼用于无痛人工流产术的麻醉效果.方法 将40例行无痛人工流产术妇女随机分为试验组和对照组各20例,对照组单纯应用丙泊酚,试验组应用丙泊酚＋芬太尼,观察2组麻醉效果及并发症发生情况.结果 试验组苏醒时间短于对照组,丙泊酚用量少于对照组,术后VAS评分低于对照组,差异均有统计学意义（P〈0.05）;试验组注射痛、体动的发生率明显低于对照组,差异均有统计学意义（P〈0.05）.结论 丙泊酚复合芬太尼用于无痛人工流产术麻醉效果显著,不良反应较轻,值得临床推广应用.     

地佐辛复合丙泊酚用于宫腔镜手术的麻醉

目的 比较地佐辛复合丙泊酚用于宫腔镜手术麻醉的效果与安全性.方法 选择宫腔镜检查+分段诊刮及电切术90例,随机分为芬太尼组、瑞芬太尼组和地佐辛组各30例.瑞芬太尼组持续静脉输注瑞芬太尼0.1μg/(kg·min),2 min后静脉注射丙泊酚1.5 mg/kg.芬太尼组先静脉注射芬太尼1μg/kg,2 min后再静脉注射丙泊酚1.5 mg/kg.地佐辛组先静脉注射地佐辛0.1 mg/kg,2 min后再静脉注射丙泊酚1.5 mg/kg.观察并记录3组麻醉效果,循环、呼吸、血氧饱和度(Sp02)变化情况,起效时间,苏醒时间,丙泊酚用量,记录麻醉效果及不良反应.结果 地佐辛组低血压、心动过缓发生率低于瑞芬太尼组、芬太尼组[3.3％(1/30)比16.7％ (5/30)、10.0％ (3/30);0比10.0％ (3/30)、6.7％(2/30),均P＜0.05].瑞芬太尼组较地佐辛组、芬太尼组呼吸抑制明显(P＜0.05).3组镇痛效果差异无统计学意义(P＞0.05),芬太尼组相对地佐辛组、瑞芬太尼组丙泊酚用量最大[(193±13)mg比(160±14)mg,(140±12)mg,P＜0.05].结论 地佐辛复合丙泊酚应用于宫腔镜手术安全有效.