术前化疗对胃肠道肿瘤患者丙泊酚药代动力学的影响

Effect of preoperative chemotherapy on pharmacokinetics of propofol in patients with gastrointestinal cancer undergoing surgery

目的探讨术前化疗对胃肠道肿瘤患者丙泊酚药代动力学的影响。方法 24例择期行全身麻醉手术的胃肠道恶性肿瘤患者按术前是否接受辅助化疗分为化疗组(C组)和非化疗组(N组),每组12例。采用丙泊酚诱导后,以七氟醚、雷米芬太尼维持麻醉。采用高效液相色谱-荧光测定法测定丙泊酚血药浓度,计算两组患者药代动力学参数。观察患者术后恢复情况及警觉-镇静(OAAS)评分。结果两组患者的药代动力学参数无统计学差异(P>0.05)。与N组相比,C组患者术后自主呼吸恢复时间、拔管时间延长,OAAS评分降低(P<0.05)。结论术前化疗对胃肠道肿瘤患者丙泊酚药代动力学无明显影响,但术前化疗患者术后恢复较未化疗患者差。

Objective To explore the effect of preoperative chemotherapy on pharmacokmetxcs of propofol in the patients with gastrointestinal cancer undergoing surgery. Methods Twenty-four patients undergoing selective gastrointestinal cancer surgery under general anesthesia were divided into two groups of C（received neoadjuvant chemotherapy before surgery, 12 cases） and N（without history of neoadjuvant chemotherapy, 12 cases）. Intravenous Propofol concentration of venous blood samples inhalation anesthesia was used in both groups. was measured using high performance liquid chromatography-fluorescence detection method. The pharmacokinetic parameters were calculated. Postoperative recovery and observer＇s assessment of alertness/sedation（OAAS）scores were observed. Results There was no significant difference in the pharmacokinetic parameters between two groups （P〉0. 05）. Compared with group N, the times of spontaneous breathing recovery and tracheal extubation were longer and OAAS scores were lower in group C（P〈0. 05）. Conclusion Preoperative chemotherapy has no obvious effect on pharmacokinetics of propofol in the patients with gastrointestinal cancer undergoing surgery, but postoperative recovery of patients received preoperative chemotherapy is worse than that of patients without chemotherapy.