Department of Clinical Pharmacy and Biopharmacy, Poznań University of Medical Sciences, ul. Św. Marii Magdaleny 14, 61-861, Poznan, Poland.
Surgery Department, Public Health Care Centre in Kępno, ul. Szpitalna 7, 63-600, Kępno, Poland.
Pharmacol Rep. 2020 Jun;72(3):763-768. doi: 10.1007/s43440-019-00042-9. Epub 2020 Jan 8.
Ketoprofen is an analgesic drug commonly applied in the postoperative period, e.g., to patients after laparoscopic cholecystectomy. Many patients who undergo this procedure are obese. As pathophysiological changes are observed in obesity, the efficacy of ketoprofen may be altered in this group of patients. The aim of the study was to compare the pharmacokinetic parameters and analgesic effect of ketoprofen administered to obese and non-obese patients after laparoscopic cholecystectomy.
The study was conducted on 41 patients after laparoscopic cholecystectomy, who were divided into two groups: obese (n = 21) and non-obese (n = 20). Ketoprofen was administered intravenously at a dose of 100 mg. Plasma ketoprofen concentrations were measured by means of validated high-performance liquid chromatography with ultraviolet detection. The pharmacokinetic parameters of the drug were calculated using the non-compartmental method. Additionally, pain intensity was assessed during the study using NRS scale.
The obese patients had significantly lower AUC (1.4-fold), AUMC (1.8-fold), AUMC (3.2-fold), MRT (1.4-fold), MRT (2.3-fold), t (2.3-fold) and V/kg (2.3-fold) and higher k (2.2-fold) than the non-obese group. Moreover, 4 h and 6 h after the administration of the drug, pain intensity was significantly higher in the obese patients.
The drug was eliminated faster and the analgesic effect of ketoprofen in the obese patients was decreased as compared with the non-obese subjects. However, pain intensity did not increase to the level, which required additional analgesic treatment. Therefore, it seems that dosage adjustment of intravenous ketoprofen is not necessary in obese patients.
酮洛芬是一种常用于术后的镇痛药物，例如腹腔镜胆囊切除术后的患者。许多接受该手术的患者肥胖。由于肥胖会引起病理生理变化，酮洛芬在这群患者中的疗效可能会发生改变。本研究旨在比较腹腔镜胆囊切除术后肥胖和非肥胖患者给予酮洛芬的药代动力学参数和镇痛效果。
本研究纳入了 41 例腹腔镜胆囊切除术后的患者，将其分为两组：肥胖组（n = 21）和非肥胖组（n = 20）。酮洛芬以 100mg 的剂量静脉给药。通过经验证的高效液相色谱法结合紫外检测法测定血浆中酮洛芬的浓度。采用非房室模型法计算药物的药代动力学参数。此外，在研究期间使用 NRS 量表评估疼痛强度。
肥胖患者的 AUC（低 1.4 倍）、AUMC（低 1.8 倍）、AUMC（低 3.2 倍）、MRT（低 1.4 倍）、MRT（低 2.3 倍）、t（低 2.3 倍）和 V/kg（低 2.3 倍）明显低于非肥胖组，而 k（高 2.2 倍）则更高。此外，给药后 4 小时和 6 小时，肥胖患者的疼痛强度明显更高。
与非肥胖患者相比，该药物在肥胖患者中的消除速度更快，镇痛效果降低。然而，疼痛强度并未增加到需要额外镇痛治疗的程度。因此，似乎不需要对肥胖患者调整静脉内酮洛芬的剂量。
