摘要
①目的 比较舒芬太尼在先天性心脏病（CHD）与腹部手术患者的药代动力学特征.②方法 随机选择ASA Ⅱ～Ⅲ级的CHD心内矫治术和腹部手术患者各8例,按手术类型分为CHD患者和腹部手术患者两组.全身麻醉后前臂静脉一次性注射舒芬太尼5μg/kg或2μg/kg,并在静脉注药后1、3、5、10、20、30、60、120、180、240和360min,采肝素抗凝血浆1mL置入密封真空试管中,-80℃低温保存待测.用液相色谱-质谱联用法测定血浆舒芬太尼浓度,3P97药理学程序计算药代动力学参数.③结果 舒芬太尼在CHD和腹部手术患者的血药浓度与时间曲线可用三指数函数方程表示.两组间的P、A、B、 t1/2α、k21、k13、Vc、Vd、CL和AUC差异有统计学意义（P〈0.05～0.01）.CHD患者的P、A、B分别是腹部手术患者的4.5,4.5和3.0倍（P〈0.01）, Vc、Vd和AUC分别为1.6倍、1.7倍和3.9倍,而CL约为其2/3.④结论 舒芬太尼在CHD和腹部手术患者的药代动力学均可用三室模型描述,体外循环血液稀释和心内分流及其腹内压的增加均可影响舒芬太尼的药代动力学特征.
Objective To compared phailnacokinetics of domestic Sufentanil in patients undergoing intracardiac trian for congenital heart disease（CHD） and abdominal surgery. Methods Sixteen ASA Ⅱ or Ⅲ patients undergoing open heart surgery and abdominal surgery were divided into intracardiac trian for CHD group and abdominal surgery group,8 cases in each group. Intravenous and intra - arterial cannulae were placed. According to the type of surgery, after general anesthesia Sufentanil 5 μg/kg or 2μg/kg was administcred as a rapid bolus intravenously. Blood samples were obtained at 1,3,5,10,20,30, 60,120,180,240min and 360 min after Sufentanil injection. 1 mL plasma was immediately separated from blood samples and stored at - 80℃. Plasma Sufentanil concentration were determined by liquid chromatography - mass spectrometry, and pharmacokinetic parameters were calculated by 3P97 pharmacology program. Results A tri - exponential equation optimally described the Sufentanil dose decay curve in patients undergoing intracardiac trian for CHD and abdominal surgery. Blood concentrations at different time points in patients with CHD were higher than the abdominal surgery patients （ P 〈 0.01 ）. There were significant difference in P, A, B, t1/2 α, k21, k13, Vc, Vd, CL and AUC between two groups（ P 〈 0.05 - 0.01 ）. P, A and B in intracardiac trian for CHD group were 4.5,4.5 and 3.0 times greater than those in abdominal surgery（ P 〈 0. 01 ）. Vc, Vd and AUC werel. 6,1.7and3.9times respectively, but CL was relatively low. Conclusion pharmaeokinetics in patients with CHD and abdominal surgery are available for three compartments, extracorporeal circulation heinodilution and intra - abdomonal pressure increasing and intraeardiac shunt could affect the pharmacokinetics of Sufentanil.
出处
《华北煤炭医学院学报》
2010年第6期768-770,共3页
Journal of North China Coal Medical College
基金
唐山市科技局指令性项目(编号:07130206A-4-7)
关键词
舒芬太尼
腹部手术
先天性心脏病
药代动力学
Domestic Sufentanil. Abdominal surgery. Congenital heart disease. Pharmacokinetics
