摘要
目的 探讨靶控输注芬太尼对异丙酚药代动力学的影响。方法 24例行结肠或直肠癌根治术患者,AsAⅠ-Ⅱ级,随机分为异丙酚复合硬膜外组(A组,n=8),异丙酚复合2 ng·ml-1芬太尼组(B组,n=8),异丙酚复合4 ng·ml-1芬太尼组(C组,n=8),三组患者均采用靶控方式输注芬太尼与异丙酚,异丙酚靶浓度均为3μg·ml-1。测定靶控输注中及停止输注后异丙酚的血浆浓度,并拟合得到各项药代动力学参数。结果 异丙酚药代动力学模型符合三室开放模型。药代动力学参数:快速分布半衰期(t1/2α)、慢速分布半衰期(t1/2β)、消除半衰期(t1/2γ)、浓度-时间曲线下面积(AUC)、清除率(CL)及中央室容积(Vc),各组间比较差异无显著性(P>0.05)。结论 靶控输注临床剂量的芬太尼(2ng·ml-1与4 ng·ml-1)并不影响异丙酚的药代动力学特性。
Objective There has been controversy about the effect of fentanyl on the pharmacokinetics of propofoL The purpose of this study was to evaluate the effect of fentanyl on pharmacokinetics of propofol administered by target - controlled infusion (TCI) .Methods Twenty-four ASA Ⅰ-Ⅱpatients (13 male, 11 female), aged 52-74 yr scheduled for colo-rectal cancer operation were randomly assigned to three groups ( n = 8 in each group) : group A propofol + epidural block; group B propofol + fentanyl (2 ng·ml-1) and group C propofol + fentanyl (4 ng·ml-1 ) . The patients were unpremedicated. Left radial artery was cannulated for BP monitoring and blood sampling and right internal jugular vein was cannulated for infusion of propofol and fentanyl. Scopolamine 0.3 mg was given iv before induction of anesthesia. In all the 3 groups propofol was administered by TCI at a target blood concentration of 3uuuuug·ml-1 for induction and maintenance of anesthesia. In group A epidural block was performed at T12-L1 or Ll-2 before induction of anesthesia. In group B and C fentanyl was given by TCI with propofol concomitantly at a target concentration of 2 ng·ml-1 (group B) or 4 ng·ml-1 (group C). As soon as the patients fell asleep succinylcholine 1.5 mg·kg-1 was given iv to facilitate tracheal intubation . Intermittent iv boluses of vecuronium were given for maintenance of muscle relaxation during operation. TCI of both propofol and fentanyl were terminated 10 min before the end of operation. Blood samples were taken after propofol was being given by TCI for 30, 60, 90, 120 min, at termination of TCI propofol and 2, 4,6,8, 10, 15, 30, 45 min, 1,2,3,4, 5, 6, 8, 12, 24 h after TCI propofol for determination of plasma concentration of propofol and pharmacokinetic parameters were calculated using computer program 3P97. Results The blood concentration versus time curve for propofol was fitted to a three-compartmnet modal. There was no significant difference in the pharmacokinetic profile of propofol (t1/2α, t1/2β, t1/2γ,AUC, CL, Vc)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2003年第10期737-739,共3页
Chinese Journal of Anesthesiology
