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研究生:呂志成
研究生(外文):Chih-Cherng Lu
論文名稱:全身麻醉劑脱氟醚在誘導麻醉與排除甦醒期之藥物動力學: 血中脱氟醚濃度測定
論文名稱(外文):PHARMACOKINETICS OF DESFLURANE DURING INDUCTION AND ELIMINATION:DETERMINATION OF BLOOD DESFLURNE CONCENTRATION
指導教授:陳大樑陳大樑引用關係
學位類別:博士
校院名稱:臺北醫學大學
系所名稱:臨床醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:英文
論文頁數:67
中文關鍵詞:氟醚誘導麻醉麻醉甦醒肺泡通氣藥物動力學動脈血脱氟醚濃度
外文關鍵詞:Desfluraneinductionemergencealveolar ventilationpharmacokineticsarterial blood concentration
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CONTENTS
CONTENTS I
ABBREVIATIONS IV
ABSTRACT VII
1. INTRODUCTION 1
2. CONCEPTION FRAMEWORKS AND SPECIFIC AIMS 6
2.1. Conception Frameworks 6
2.2. Specific Aims 7
3. METHODS 8
3.1. Study I: Hyperventilation accelerates the rise of arterial blood concentrations of desflurane in gynecologic patients. 8
3.2. Study II: Pharmacokinetic of desflurane in respiratory gas and blood during 20-min elimination after cardiac surgery. 18
3.3. Study III: Awakening arterial blood concentration of desflurane and emergence from general anesthesia in gynecological patient 24
4. RESULTS 28
4.1. Results of study I: 28
4.2. Results of study II 31
4.3. Results of study III 33
5. DISCUSSION AND CONCLUSION 36
6. FUTURE WORKS 48
7. REFERENCES 49
Figure 1. A example to create a standard calibration curve for desflurane 56
Figure 2. Schematic representation of time frame for coronary arterial bypass grafting surgery with cardiopulmonary bypass under desflurane anesthesia. 57
Figure 3. Arterial desflurane concentration (Ades) time curves under three different ventilatory states, including hyperventilation (--▼--), normal ventilation (--▲--), and hypoventilation (--△--) during 40 minutes of study. 58
Figure 4. End-tidal desflurane concentration (CEdes) time curves under three different ventilatory states, including hyperventilation (--▼--), normal ventilation (--▲--), and hypoventilation (--△--), during 40 minutes of study. 59
Figure 5. Desflurane concentrations-time curves over a period of 20 min before and after cessation of inspired desflurane administration. 60
Figure 6. The arterial concentrations just prior to discontinue 6% desflurane 61
Figure 7. The Bland-Altman plot displays the differences arterial concentration and end-tidal concentration at awakening plotted against the average of the two concentrations with indication of awakening time (i.e., 3-4, 5 and 6-10 min). 62
Figure 8. The time to awakening 63
9. TABLES 64
Table 1. Hemodynamic variables in the three ventilation groups at 5, 10, 20, 30, and 40 min of the study. 64
Table 2. Generalized estimating equation analysis for arterial desflurane concentrations comparing the hyperventilation and hypoventilation groups to the normal group 65
Table 3. Mean (SD) of the slopes of Ades-over-time curves in the three groups at different periods. 66
Table 4 The fitting of CEdes, Jdes and PAdes, Ades versus time curves with bi-exponential equation (n=16). 67
Table 5 The CEdes, Ades, Jdes, PAdes, and Ades: CEdes ratio under 7 % inspired desflurane anesthesia at 0 min (just prior to cessation of desflurane; as basal level of desflurane maintenance phase), and at 1, 3, 5, 10, 15 and 20 minutes after desflurane discontinuation (n=16). 68
10. APPENDIX:
Lu CC, Lin TC, Hsu CH, Yu MH, Chen TL, Chen RM, Ku CH and Ho ST. Hyperventilation accelerates the rise of arterial blood concentrations of desflurane in gynecologic patients. Clinics, 2012, in press
Lu CC, Tsai CS, Hu OYP, Chen RM, Chen TL, Ho ST, Gan TJ. Pharmacokinetic of desflurane in respiratory gas and blood during 20-min elimination after cardiac surgery. Journal of Formosa Medical Association , 2012, in press
Lu CC, Lin TC, Hsu CH, Wu GJ, Lee MShyuan Chen TL, Chen RM, Ho ST. Awakening arterial blood concentration of desflurane and emergence from general anesthesia in gynecological patients. PLOS

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