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[肥胖对异氟烷药代动力学和药效学的影响]

[Influence of obesity on pharmacokinetics and pharmacodynamics of isoflurane].

作者信息

Gong Zhi-yi, Ye Tie-hu, Huang Yi-dan, Sang Nuo-er, Duan He, Ren Hong-zhi

机构信息

Department of Anesthesiology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2003 Oct;25(5):615-8.

Abstract

OBJECTIVE

To observe the effect of obesity on pharmacokinetics and pharmacodynamics of isoflurane.

METHODS

Twenty-six patients undergoing cholecystectomy were divided into obese group (Group A, BMI > or = 27, n = 13) and normal body weight group (Group N, BMI < or = 24, n = 13) according to body mass index (BMI). All patients were given to the same isoflurane anesthesia. Inspired and end-expired concentrations of isoflurane were monitored and uptake fraction of isoflurane were calculated.

RESULTS

Isoflurane concentrations of vaporizer in Group A [(1.8 +/- 0.3)%] were evidently higher than those in Group N [(1.5 +/- 0.1)%] at all observed points (P < 0.05 or P < 0.01). Uptake fraction of isoflurane in Group A were higher than those in Group N at observed points (P < 0.05, P < 0.01 or P < 0.001), but there were no differences in the time when isoflurane concentration was lowered to 50% and awake time between the two groups after discontinuing inhaling isoflurane.

CONCLUSIONS

Obese patients demand higher inspired concentration and uptake of isoflurane than those in normal weight patients but discharge of isoflurane was influenced by obesity within the observed period of (66 +/- 33) min.

摘要

目的

观察肥胖对异氟烷药代动力学和药效学的影响。

方法

26例行胆囊切除术的患者根据体重指数(BMI)分为肥胖组(A组,BMI≥27,n = 13)和正常体重组(N组,BMI≤24,n = 13)。所有患者均给予相同的异氟烷麻醉。监测异氟烷的吸入浓度和呼气末浓度,并计算异氟烷的摄取分数。

结果

在所有观察点,A组蒸发器中异氟烷浓度[(1.8±0.3)%]明显高于N组[(1.5±0.1)%](P<0.05或P<0.01)。观察点A组异氟烷摄取分数高于N组(P<0.05、P<0.01或P<0.001),但停止吸入异氟烷后,两组异氟烷浓度降至50%的时间和苏醒时间无差异。

结论

肥胖患者比正常体重患者需要更高的异氟烷吸入浓度和摄取量,但在(66±33)分钟的观察期内,肥胖会影响异氟烷的排出。

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