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[20% 脂质乳剂对兔持续输注丙泊酚的药物浓度、分布容积及药理效应的影响]

[Influence of 20% lipid emulsion on drug concentration, distribution volume and pharmacology effect of continuous infusion of propofol in rabbits].

作者信息

Lu Mei-Zhu, Kang Yan, Chen Yao, Wang Bo, Yin Wan-Hong, Kang Yi

机构信息

Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2013 Jul;44(4):619-23.

Abstract

OBJECTIVE

To investigate the influence of 20% lipid emulsion on drug plasma concentration, distribution volume and pharmacology effect of propofol administered with constant rate intravenous infusion in rabbits.

METHODS

Propofol was intravenously administrated at a constant rate of 70 mg/(kg x h) in propofol group (P group, n = 8), low rate lipid group (L group, n = 8), high rate lipid group (H group, n = 8) and saline group (S group, n = 8) within 2 h. After 60 min, different agents were administrated in L group (20% lipid emulsion with rate of 0.3 mL/(kg x h)), H group (20% lipid emulsion with rate of 15 mL/(kg x h)), S group (saline with rate of 15 mL/(kg x h)) for another 60 min respectively. Blood samples were taken to measure the plasma concentration and calculate the pharmacokinetic parameters at the following time points: 30, 60, 65, 70, 80, 90, 120 min after the start of propofol infusion and 10, 20, 30, 60, 120, 180 min after the termination of propofol infusion. Brain tissues were also taken to measure propofol concentration. Related information about vital signs and pharmaceutical effects were recorded.

RESULTS

High rate lipid infusion was associated with elevated propofol plasma concentration and reduced volume of distribution. The volume of distribution based on the terminal phase (V): P group, (34.56 +/- 16.11) mL; L group, (33.37 +/- 29.87) mL; H group,(7.29 +/- 3.20) mL; S group,(35.46 +/- 13.58) mL; P < 0.05). The volume of distribution at steady state (Vss): P group, (11.13 +/- 3.21) mL; L group, (13.87 +/- 4.09) mL; H group, (4.82 +/- 1.46) mL; S group, (11.61 +/- 4.11) mL P < 0.05)). Painful stimulation existences were higher at 90,120 min and the mean arterial pressure and heart rate were higher in H group (P < 0.05). The propofol concentration in brain tissue was lower in H group at 120 min (P < 0.05).

CONCLUSION

Amelioration of pharmacology effect of propofol with high rate lipid infusion is associated with reduced V, Vss, elevated propofol plasma concentration and lowered propofol brain tissue concentration. 20% lipid will not influence these indice when infused with low rate, indicating that lipid in TPN will not change the sedation effects of propofol.

摘要

目的

探讨20%脂质乳剂对兔静脉恒速输注丙泊酚时药物血浆浓度、分布容积及药理效应的影响。

方法

将兔分为丙泊酚组(P组,n = 8)、低剂量脂质组(L组,n = 8)、高剂量脂质组(H组,n = 8)和生理盐水组(S组,n = 8),于2小时内以70mg/(kg·h)的恒速静脉输注丙泊酚。60分钟后,L组(以0.3mL/(kg·h)的速率输注20%脂质乳剂)、H组(以15mL/(kg·h)的速率输注20%脂质乳剂)、S组(以15mL/(kg·h)的速率输注生理盐水)分别再持续输注60分钟。在丙泊酚输注开始后的30、60、65、70、80、90、120分钟以及丙泊酚输注结束后的10、20、30、60、120、180分钟采集血样,测定血浆浓度并计算药代动力学参数。同时采集脑组织测定丙泊酚浓度。记录相关生命体征及药理效应信息。

结果

高剂量脂质输注使丙泊酚血浆浓度升高,分布容积减小。终末相分布容积(V):P组,(34.56±16.11)mL;L组,(33.37±29.87)mL;H组,(7.29±3.20)mL;S组,(35.46±13.58)mL;P<0.05)。稳态分布容积(Vss):P组,(11.l3±3.21)mL;L组,(13.87±4.09)mL;H组,(4.82±1.46)mL;S组,(11.61±4.11)mL,P<0.05)。在90、120分钟时,H组疼痛刺激反应较高,平均动脉压和心率也较高(P<0.05)。120分钟时,H组脑组织中丙泊酚浓度较低(P<0.05)。

结论

高剂量脂质输注改善丙泊酚药理效应与分布容积V、Vss减小、丙泊酚血浆浓度升高及脑组织丙泊酚浓度降低有关。低剂量输注20%脂质乳剂不影响这些指标,提示全胃肠外营养中的脂质不改变丙泊酚的镇静效果。

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