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The Study of Pharmacodynamics in Spleen-Qi Deficiency Patients Sedated by Propofol Via TCI

Author: SunXiaoLin
Tutor: PanFeiPeng
School: Guangzhou University of Traditional Chinese Medicine
Course: Traditional Chinese Medicine
Keywords: Propofol Pharmacodynamics Spleen-Qi deficiency TCI
CLC: R96
Type: Master's thesis
Year: 2010
Downloads: 25
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Abstract

BackgroundThe Hypothesis of Syn-PK was introduced by HUANG Xi et al. in 1991. Later, the hypothesis that PK is much influenced by the function of spleen was introduced.There was research result that concentration of TMPP was higher in rats which were in the status spleen-qi deficiency than in healthy rats We have found phenomenon that the dose of propofol for anesthesia in slim patients was larger than that of strong patients. It is considered that physical type of TCM may have influence on anesthesia. In Guangdong Province, there are a lot of people are in the status of spleen-qi deficiency. So we studied the influence of the function of spleen deficiency on pharmacodynamics of propofol.ObjectiveWe aim to explore whether the function of spleen could have an effect on the pharmacodynamics of propofol, and to investigate the significance of the function of spleen, which is to governs the transportation and transformation, in pharmacokinetics.MethodsPatients who were going to have an elective operation and met the inclusion criteria were divided into two groups according to their physical type. No premedication was given. All of them were sedated by propofol via TCI under the same scheme. The propofol infusion was started to provide an initial plasma concentration of 2.5μg/ml, and increased by 0.5μg/ml every 10 min until BIS value was less than or equal to 65 (T1). Then the infusion was stopped. We called the patients’name every 10 s until they regained consciousness and could do what we told them to(T2). The infusion was completed before start of operation. Arterial blood was extracted at T1, T2. Propofol plasma concentration was measured by using the method of HPLC-fluorescence detection. Statistical package SPSS13.0 was used. Enumeration data was analyzed by t-test, rank-sum test. Measurement data was analyzed by Chi-square test or Fisher’s exact. The data was considered to be significantly different if P<0.05.ResultsRBC, TP, ALB were not significantly different between two groups (P>0.05). But the value of Hb, HCT in Group SQD were significantly lower (P>0.05). When the patients in two groups were in the same depth of anesthesia, The mean arterial blood propofol concentrations of the moment T1(CpT1) were not significantly different in either group (P>0.05):Group SQD 3.21±1.62μg/ml and Control Group 3.32±0.71μg/ml. So was CpT2:Group SQD 1.16±0.40μg/ml and Control Groupl.12±0.35μg/ml.ΔT1,ΔT2 of Group SQD was much longer than that of Control Group (P<0.05) butΔT of Group SQD was shorter (P<0.05). Dose of propofol of Group SQD was much larger than that of Control Group (P< 0.001).ConclusionCompared with the Control Group, for the patients in the condition of Spleen-Qi deficiency, the actual concentration of propofol was not significantly different. However, it took more time and consumed more propofol for them to be sedated to the same depth of anesthesia. But they (Group SQD) regained consciousness more quickly. The mechanism is complicated and still not clear.

The Study of Pharmacodynamics in Spleen-Qi Deficiency Patients Sedated by Propofol Via TCI

Abstract

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