Altmayer P, Büch U, Hutschenreuter K, Büch H P
Institut für Anaesthesie, Universität des Saarlandes, Homburg/Saar, FRG.
Acta Anaesthesiol Scand. 1987 Nov;31(8):756-61. doi: 10.1111/j.1399-6576.1987.tb02659.x.
In man, a change of thiopental pharmacokinetics was observed under halothane anesthesia, but not when patients were anesthetized with enflurane and isoflurane. After an initial subanesthetic dose of 50 mg thiopental, the concentrations in serum (T) were determined over 15 min (4 samples). From these T-values the pharmacokinetic parameters Vc (central volume of distribution), t1/2 alpha and Cl were established (control). 16 min after the first thiopental dose, one of the inhalation anesthetics was administered (randomized). After 45 min exposure to the respective inhalation anesthetic (2-3 MAC in combination with N2O, steady-state a second dose of 50 mg thiopental was injected and the T-values were determined again over 15 min. The T-values of the control course varied considerably; the logarithmic frequency distribution revealed two distinct subgroups of patients, A and B, with characteristic Vc and t1/2 alpha. Both subgroups were influenced by the volatile anesthetics in a similar way with regard to pharmacokinetic parameters. With halothane, Vc was decreased and t1/2 alpha was shortened. In contrast, enflurane and isoflurane did not affect the pharmacokinetic parameters.
在人体中，观察到在氟烷麻醉下硫喷妥钠的药代动力学发生了变化，但在患者接受恩氟烷和异氟烷麻醉时未观察到这种变化。在给予初始亚麻醉剂量50mg硫喷妥钠后，在15分钟内（采集4个样本）测定血清浓度（T）。根据这些T值确定药代动力学参数Vc（中央分布容积）、t1/2α和Cl（对照）。在首次给予硫喷妥钠剂量16分钟后，给予一种吸入麻醉药（随机）。在接触相应的吸入麻醉药45分钟后（与N2O联合使用2-3MAC，稳态），注射第二剂50mg硫喷妥钠，并在15分钟内再次测定T值。对照过程的T值差异很大；对数频率分布显示出患者的两个不同亚组，A组和B组，具有特征性的Vc和t1/2α。就药代动力学参数而言，两个亚组受挥发性麻醉药的影响方式相似。使用氟烷时，Vc降低，t1/2α缩短。相比之下，恩氟烷和异氟烷不影响药代动力学参数。
