Breath by breath exhaled propofol monitoring for clinical practice

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K08867
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Yokohama City University (2021); Showa University (2018-2020)
• Principal Investigator: MASUI Kenichi 横浜市立大学, 医学研究科, 特任准教授 (20303430)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 呼気プロポフォール濃度 / ブレスバイブレスモニタ / プロポフォール麻酔

Outline of Final Research Achievements

We examined whether exhaled propofol concentrations measured by a breath-by-breath monitor, developed specially for clinical anesthesia, follow changes in propofol plasma concentrations during propofol anesthesia. Patients undergoing hepatic resection were anesthetized using propofol. At the start and the end during each Pringle’s maneuver (a procedure to control blood loss during liver resection by blocking blood vessels entering the liver), exhaled and plasma propofol were measured, simultaneously. When measured plasma propofol concentrations were increased and decreased by clamping and declamping the vessels, respectively, exhaled propofol concentrations were also increased and decreased, respectively. These results indicate that the breath-by-breath exhaled propofol concentration monitoring can monitor changes in plasma propofol concentration in clinical practice.

Free Research Field

麻酔薬理学

Academic Significance and Societal Importance of the Research Achievements

プロポフォールによる全静脈麻酔には、覚醒時喉頭痙攣・覚醒時興奮・術後の悪心嘔吐抑制などの利点があるが、薬物濃度のリアルタイム連続測定ができず、効果の個人差が大きいことから、現状では適切な投与が難しい。プロポフォールの過量投与は覚醒遅延・術後の鎮静効果遷延、頻度は稀だが重篤なプロポフォール注入症候群を起こしうる。
本研究ではブレスバイブレス呼気プロポフォール濃度モニタリングが、薬物濃度のリアルタイム測定を可能にし、血中濃度の増減を評価できることを示した。実測濃度モニタリングは、術中の適切なプロポフォール投与を容易にし、術中術後の合併症を減らすことができ、安全な全身麻酔に大きく貢献すると考えられる。