临床静脉滴注过程对注射用地西泮浓度的影响

The influence of clinical course of intravenous injection on the diazepam concentration

目的探讨临床注射用地西泮静脉滴注过程中的浓度变化,为临床合理应用静脉滴注地西泮浓度提供依据。方法以5%葡萄糖注射液为溶媒,分别模拟临床避光静脉滴注和常规静脉滴注过程;采用HPLC法测定药液中地西泮浓度,分别考察静脉滴注过程中滴注速度、药物初始浓度、滴注时间等因素对地西泮浓度的影响。结果避光静脉滴注组各因素对于地西泮浓度影响小于常规静脉滴注组,避光静脉滴注组各因素下地西泮浓度略高于常规静脉滴注组。2组中初始药物浓度和滴注速度对地西泮浓度的影响较大,尤其在低水平组(P<0.05,n=6);初始药物浓度考察时高浓度组较低浓度组地西泮的损失率小(P<0.05,n=6),而滴注速度在中水平组60滴/min时,2组对地西泮浓度影响最小,差异无统计学意义(P>0.05,n=6)。结论在常规静脉滴注和避光静脉滴注过程中初始药物浓度和滴注速度对地西泮浓度的影响较大,是主要影响因素,建议在临床使用地西泮静脉滴注过程中,滴注速度尽可能选择为60滴/min,而初始药物浓度应根据患者具体病情选择合适药物浓度。

Objective To investigate the concentration change of diazepam injection in the course of intravenous infusion,in order to provide the basis for the clinical application of intravenous diazepam concentration. Methods The 5% Glucose Injection was as a solvent. And simulated the process of avoiding light intravenous infusion and conventional intravenous infusion. Determinated the concentration of the liquid diazepam by HPLC. The effects of infusion rate, initial drug concentration, infusion time and other factors on the concentration of diazepam were studied in the process of infusion. Results The factors affecting the concentration of diazepam in avoiding light intravenous infusion group was less than that of conventional intravenous infusion group. The concentration of diazepam in avoiding light intravenous infusion group was slightly higher than that of conventional intravenous infusion group. The initial infusion rate and drug concentration groups had the greater impact on the concentration of diazepam, especially in the low group （ P 〈 0.05, n = 6） ; For initial drug concentration, the loss rate of diazepam in the high concentration group was smaller than that in the low concentration group （ P 〈 0.05, n = 6） ; While in the middle level （60 drops of/min） , the effect of 2 groups on the diazepam concentration was the smallest, the difference was not statistically significant （ P 〉 0.05, n = 6）. Conclusions In the course of conventional intravenous infusion and avoiding light intravenous infusion, the initial drug concentration and infusion rate have great influence on the concentration of diazepam, it is the main influencing factor. In the clinical use of intravenous injection of diazepam, infusion rate as far as possible set as 60 drops/min. Initially, we should choose the appropriate drug concentration according to the patientg specific condition.