ropofol(diprivan)andit'sadverseeffectinanesthesia：丙泊酚（异丙酚）和它的不良影响在麻醉

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1、Propofol(Diprivan)andIt’sAdverseEffectinAnesthesiaLiu,Chih-Min2003-8-192,6-diisopropylphenolPropofolIndications:Anesthesia,generalPregnancyCategoryBFDAApproved1989Oct2,6-diisopropylphenolmolecularweightof178.27.isotonicpHof7-8.5MechanismofActionTheactualmechanismofactionisunknown,but

2、itispostulatedthatpropofolmediatesactivityoftheGABAreceptors.rapidsedationwithminimalexcitatoryactivitynoanalgesicpropertiesPharmacokineticseliminatedbyhepaticconjugationtoinactivemetabolites,excretedbythekidneyNodosageadjustmentsareneededforpatientswithrenalorhepaticfailureGeriatrics

3、age-relateddecreaseinvolumeofdistributionhigherpeakplasmaconcentrationscardiorespiratoryeffectsincludinghypotension,apnea,airwayobstruction,and/oroxygendesaturationINDICATIONSANDUSAGE:inductionand/ormaintenanceofanesthesiainadultpatientsandpediatricpatientsgreaterthan3yearsofagenotrec

4、ommendedforobstetricsnotrecommendedforuseinnursingmothersPediatricUsenotrecommendedin:inductionofanesthesiainpatientsyoungerthan3yearsofagemaintenanceofanesthesiainpatientsyoungerthan2monthsofagenotindicatedforuseinpediatricpatientsforICUsedationCardiacAnesthesiawell-studiedincoronary

5、arterydisease,butvalvularorcongenitalheartdiseaseislimiteddecreaseinbloodpressurethatissecondarytodecreasesinpreloadandafterloadlowerheartratespossiblyduetoreductionofthesympatheticactivityand/orresettingofthebaroreceptorreflexesanticholinergicagentsshouldbeadministeredwhenincreasesin

6、vagaltoneareanticipatedInductionofGeneralAnesthesiaHealthyAdultsLessThan55YearsofAge:40mgevery10secondsuntilinductiononset(2-2.5mg/kg).Elderly,Debilitated,orASAIII/IVPatients:20mgevery10secondsuntilinductiononset(1-1.5mg/kg).CardiacAnesthesia:20mgevery10secondsuntilinductiononset(0.5-

7、1.5mg/kg).NeurosurgicalPatients:20mgevery10secondsuntilinductiononset(1-2mg/kg).PediatricPatients-healthy,from3-16yearsofage:2.5-3.5mg/kgadministeredover20-30seconds.MaintenanceofGeneralAnesthesiaHealthyAdultsLessThan55YearsofAge:100-200μg/kg/min(6-12mg/kg/h).Elderly,Debilitated,ASAII

8、I/IVP