Factors influencing the sedative effect of propofol during target controlled infusion
WANG Yiluan, NAN Yang, WANG Qian, LI Jun.
Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China
Abstract：Objective: To analyze the relevant factors affecting the sedative efficacy of propofol in target-controlled infusion. Methods: A total of 100 patients scheduled for elective operation undergoing general anesthesia from March to June 2018 in the Second Affiliated Hospital of Wenzhou Medical University were included in this study. Age, gender, height, weight and body mass index (BMI), systolic blood pressure, diastolic blood pressure and blood biochemical indexes of the patients were recorded. Patients were received propofol in target-controlled infusion, and the initial plasma target concentration was set at 1.2 μg/mL. After the target concentration was steadily maintained for 30 s, the gradient was increased by 0.3 μg/mL every 30 s until the patients lost consciousness. The target plasma concentration of propofol at this time was recorded. Spearman rank correlation and rank sum test were used to analyze the correlation between each variable and the plasma target concentration, and the screened variables were included in the stepwise multiple linear regression model, finally determining the independent influencing factors. LOESS model was used to analyze the association between independent influencing factors and plasma target concentration, then the trend chart was fitted. Results: Correlation analysis showed that age, BMI, systolic blood pressure, blood glucose, urea nitrogen, urea nitrogen/creatinine and history of hypertension were significantly associated with the target plasma concentration (P<0.05). Stepwise multiple linear regression analysis showed that age, BMI, and systolic blood pressure were independent factors in the efficacy of propofol sedation (P<0.05). According to the trend chart fitted by LOESS model, the plasma target concentration decreased as the increase of age and BMI. The plasma target concentration was first increased and then decreased as the increase of systolic blood pressure. Conclusion: Age, BMI and systolic blood pressure are significant factors affecting the efficacy of propofol sedation.
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