摘要
１０例择期整形外科手术患者在Ｎ２Ｏ－Ｏ２－芬太巳或疏喷妥钠复合麻醉下于手术开始前行急性血液稀释达中度（Ｈｃｔ ２５％～３０％）。静脉注射伴库溴铵后定点取静脉血，采用荧光法测定血浆伴库溴铵浓度。经３Ｐ８７药代动力学程序包处理。结果表明：静注后伴库溴铵在人体内呈二室开放模型。血液稀释状态下其Ｖｄｓｓ增加６５．５９％，Ｖ２增加９７．４５％（Ｐ＜０．０５）由７５．３±１２．６４分延长至１２５．４９±５５．２分（Ｐ＜０．０１），ＣＩ由２．３５±０．４３ｍｌ·ｍｉｎ－１·ｋｇ－１减少到１．２６±０．２４ｍｌ·ｍｉｎ－１·ｋｇ－１（Ｐ＜０． ０５）。两组Ｖ１及ｔα均无显著差异。根据上述药代动力学变化特点可以预计在长时间手术中，血液稀释状态下的患者对伴库溴铵的首剂需求量增大而对维持剂量所需相对减少，如果多次或大剂量给药可使作用时间延长。
To evaluate the effect of acute moderate isovolemic hemodilution (AMIH) on the pharmacokinetics of pancuronium (PAN), ten adult patients, ASA grade I, undergoing plastic surgery, were randomly divided into two groups. Following anesthesia was maintained with the inhalation of nitrous oxide combined with interrnmitently intravenous fentanyl and thiopental, the status of AMIH was induced by drawing-off of the venous blood and intravenous infusion of 6% dextron and lactate Ring's solution until the hematocrit was descended to 25%-30% in group Ⅱ, and the subjects in group I served as the control. The blood samples were taken at various times after an intravenous injection of PAN 96μg·kg-1 in both groups. The plasma concentrations of PAN were measured with fluorometry, The pharmacokinetic parameters were calculated by the standard formulae. The results indicated that as compared with the control values in group I, the levels of Vdss,V2 and t increased significantly by 65. 59%, 97. 55% and 66.65% respectively (P<0.01), one of CI decreased markedly by 25. 1% (P<0.05) and t and V1 did not alter statistically in group Ⅱ (P>0. 05). It is concluded that in a state of AMIH, the Initial dose of PAN is required to increase, but the maintance dose is necessary to decrease relatively.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
1995年第11期486-489,共4页
Chinese Journal of Anesthesiology
关键词
药代动力学
血液稀释
泮库溴铵
Pharmacokinetics Pancuronium Acute moderate isovolemic hemodilution
