盐酸右美托咪定在全麻肥胖患者体内的药代动力学研究

Pharmacokinetics of dexmedetomidine hydrochloride in anesthesia obese patients

目的探讨盐酸右美托咪定注射液在中国全麻肥胖患者的药代动力学特征。方法 8例肥胖患者全身麻醉后静脉泵注盐酸右美托咪定1.0μg·kg-1,高效液相色谱-质谱联用法(HPLC-MS/MS)测定血浆中右美托咪定浓度变化。以DAS 2.1.1软件进行数据处理,计算药代动力学参数。结果盐酸右美托咪定的药代动力学参数如下:Cmax为(3.33±1.20)μg·L-1,t1/2α为(2.49±0.56)min,t1/2β为(163.41±116.41)min,V1为(162.96±43.26)L,CLz(4.02±1.18)L·min-1,AUC0-t为(123.27±55.96)μg·min·L-1,MRT0-t为152.06min。肥胖患者的AUC、Cmax、CLz、V1较正常体质量患者均显著增大(P<0.05)。结论在肥胖患者临床麻醉中,给予右美托咪定负荷剂量时,应适当减少药物剂量;维持阶段时,应适当增加药物剂量。

Objective To evaluate the pharmacokinetics of dexmedeto-midine hydrochloride injection in anesthesia Chinese obese patients.Methods Eight obese patients were intravenously injected with dexme-detomidine 1.0 μg· kg-1 after anesthesia.Concentrations of dexmedeto-midine in plasma were determined by HPLC -MS/MS.The pharma-cokinetic parameters were calculated with DAS 2.1.1 software.Results The main pharmacokinetic parameters for the obese patients were as follows：Cmax was （3.33 ±1.20） μg· L-1, t1/2αwas （2.49 ± 0.56 ） min, t1/2βwas （ 163.41 ±116.41 ） min, V1 was （ 162.96 ± 43.26） L, CLz was （4.02 ±1.18） L· min-1, AUC0-t was （123.27 ± 55.96 ） μg · L-1 · min, and MRT0-t was 152.06 min.The results showed that the AUC , Cmax , CLz, and V1 were significantly higher than the patients with normal body mass （ P〈0.05 ）.Conclusion In obese patients, loading dose should be accompanied with a corresponding re-duction, but doses should be increased at maintaining stage.