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[静脉恒速输注美索比妥的药代动力学]

[Pharmacokinetics of methohexital given by constant rate intravenous infusion].

作者信息

Bally B, Payen J F, Serre-Debeauvais F, Tranchand B, Gavend M, Stieglitz P

机构信息

Département d'Anesthésie-Réanimation, CHU de Grenoble.

出版信息

Ann Fr Anesth Reanim. 1992;11(2):136-40. doi: 10.1016/s0750-7658(05)80003-6.

Abstract

The pharmacokinetic characteristics of a constant rate methohexitone infusion were studied in young ASA 1 patients undergoing maxillofacial surgery. They were randomly assigned to two groups; group M patients (n = 7) were given 9 mg.kg-1.h-1 of methohexitone for one hour, and group MF patients (n = 7) 9 mg.kg-1.h-1 of methohexitone with 7 micrograms.kg-1.h-1 of fentanyl, also for one hour. Blood samples for determining methohexitone concentrations were obtained at various times, from before the start of the methohexitone infusion up to 19 h afterwards. In twelve patients, a two-compartment model was appropriate to characterize the decrease of methohexitone concentration; for the other two (one in each group), a three-compartment model was applied. There were no statistically significant differences between the two groups. Elimination half-life in group M was 3.22 +/- 1.96 h, and total plasma clearance 8.54 +/- 2.8 ml.kg-1.min-1. The wide variations in pharmacokinetic parameters between subjects may explain some unpredictable variations in duration of action of methohexitone. Fentanyl did not modify methohexitone pharmacokinetics, which remained of the first order. However, it potentiated the barbiturate's action: extubation was only possible after stopping the infusion for 39.4 min +/- 22 min in group MF, and 15.4 min +/- 6 min in group M (p less than 0.01). At that time, plasma concentrations were respectively 3.12 +/- 0.99 mg.l-1 (group MF) and 5.71 +/- 2.09 mg.l-1 (group M), (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在接受颌面外科手术的年轻ASA 1级患者中,研究了甲氧己妥持续输注的药代动力学特征。他们被随机分为两组;M组患者(n = 7)接受9 mg·kg⁻¹·h⁻¹的甲氧己妥输注1小时,MF组患者(n = 7)接受9 mg·kg⁻¹·h⁻¹的甲氧己妥加7 μg·kg⁻¹·h⁻¹的芬太尼,同样输注1小时。在甲氧己妥输注开始前至输注后19小时的不同时间采集血样以测定甲氧己妥浓度。12例患者采用二室模型来描述甲氧己妥浓度的下降;另外2例(每组各1例)采用三室模型。两组之间无统计学显著差异。M组的消除半衰期为3.22±1.96小时,总血浆清除率为8.54±2.8 ml·kg⁻¹·min⁻¹。受试者之间药代动力学参数的广泛差异可能解释了甲氧己妥作用持续时间的一些不可预测的变化。芬太尼未改变甲氧己妥的药代动力学,其仍为一级动力学。然而,它增强了巴比妥类药物的作用:MF组在停止输注39.4分钟±22分钟后才可能拔管,M组为15.4分钟±6分钟(p<0.01)。此时,血浆浓度分别为3.12±0.99 mg·L⁻¹(MF组)和5.71±2.09 mg·L⁻¹(M组),(p<0.05)。(摘要截短至250字)

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