摘要
目的:研究心内直视手术中大剂量芬太尼的药代动力学。方法:随机选择11例心内直视手术患者,芬太尼60μg/kg静脉注射后,采集24小时桡动脉血标本,应用气相色谱—质谱法检测血浆芬太尼浓度,NONLIN软件计算药代动力学参数。结果:芬太尼药代动力学符合开放性三室模型。静脉注射芬太尼后血药浓度立刻达126.9~259.0ng/ml,在静脉注射后60分钟血药浓度下降为12.9ng/ml,有93.1%的芬太尼从血浆中被清除。有7例患者在不同时间血药浓度出现第2次和第3次高峰。手术后8小时血药浓度仍可再次增高达3.98±1.76ng/ml。结论:在大剂量芬太尼麻醉时,手术后呼吸支持应超过8小时,尤其在患者清醒、体温恢复及有随意活动时,血浆芬太尼浓度增高。
? Objective:To study the pharmacokinetics of highdose fentanyl in patients undergoing cardiac surgery Methods:Eleven patients undergoing cardiac surgery,blood samples were collected following a bolus injection of highdose(60 μg/kg)fentanyl as the sole anestheticPlasma fentanyl concentration was determined by gas chromatography/mass spectrometry(GC/MS)methodPharmacokinetic parameter were calculated with NONLIN computer program Results:The kinetics can be described by triexponential decay curvePlasma fentanyl concentration reached a peak(1269_2590 ng/ml) immediately after a bolus injection of fentanylIt decreased to 129 ng/ml in 60 min,931% of fentanyl was removed in plasma.Seven patients had a second and third peak in plasma fentanyl concentration,which reincreased to 398±176 ng/ml even at 8 h after operation Conclusion:Respiratory therapy should be continued to eight hours following the end of operation under highdoes fentanyl anesthesia,because the increased plasam fentanyl level may lead to recurrence of respiratory depression, especially when the patients consciouseness is regained and the muscle tone,body temperature and voluntary movement are recovered
出处
《中国循环杂志》
CSCD
北大核心
1998年第1期32-34,共3页
Chinese Circulation Journal