Ionescu T I, Taverne R H, Houweling P L, Drost R H, Nuijten S, Van Rossum J
Institute of Anaesthesiology, Utrecht University Hospital, The Netherlands.
Br J Anaesth. 1991 Apr;66(4):458-64. doi: 10.1093/bja/66.4.458.
We have studied the plasma concentrations (Cp) and pharmacokinetics of sufentanil injected i.v. (IVS), intradurally (IS) or extradurally (ES) under general anaesthesia in 31 patients undergoing major abdominal surgery. Sufentanil appeared in plasma very rapidly and Cpmax was also attained rapidly after both extradural and intrathecal injection. Apart from the first 2 min after injection, Cp after ES and IVS were comparable until the end of the study. Cp after ES was greater than after IS up to 0.25 h. Cp after IS was significantly greater than that after ES at 1 h and 2.5 h, and was also greater than that after IVS at 3 h. At tracheal extubation there was no difference in Cp between groups. Peak Cp values were significantly different between ES and IS, but the times taken to reach Cpmax were comparable. Plasma pharmacokinetics after ES and IS were similar. The plasma mean residence time and volume of distribution of sufentanil at steady state after ES and IS were significantly different in comparison with those after IVS.
我们研究了31例接受腹部大手术的患者在全身麻醉下静脉注射（IVS）、硬膜内注射（IS）或硬膜外注射（ES）舒芬太尼后的血浆浓度（Cp）及药代动力学。舒芬太尼在血浆中出现得非常迅速，硬膜外和鞘内注射后Cpmax也迅速达到。除注射后的前2分钟外，直到研究结束，ES和IVS后的Cp具有可比性。在长达0.25小时的时间内，ES后的Cp高于IS后的Cp。在1小时和2.5小时时，IS后的Cp显著高于ES后的Cp，且在3小时时也高于IVS后的Cp。气管拔管时，各组间的Cp无差异。ES和IS之间的峰值Cp值有显著差异，但达到Cpmax所需的时间具有可比性。ES和IS后的血浆药代动力学相似。与IVS后相比，ES和IS后舒芬太尼在稳态时的血浆平均驻留时间和分布容积有显著差异。
