Helmers J H, Noorduin H, van Leeuwen L
Eur J Anaesthesiol. 1985 Dec;2(4):347-52.
The clinical effects of an i.v. bolus dose of 50 micrograms kg-1 alfentanil were studied during surgical anaesthesia in 10 elderly patients and compared with those of the same dosage in nine young adults. Plasma samples, to determine alfentanil concentrations, were taken at regular intervals during the first hour following injection. Cardiovascular changes were minor. A transient fall in systolic blood pressure shortly after the alfentanil administration was seen in both groups but was more pronounced in the elderly patients. The quality of initial intra-operative analgesia was good in all patients. The duration of action of 50 micrograms kg-1 alfentanil, as judged by the occurrence of signs of insufficient analgesia, was longer in the elderly patients (mean: 36 min) than in young patients (mean: 22 min). The alfentanil plasma levels extrapolated for these time points were similar. Hence, the difference in duration of action must be due to the slower elimination from the body in the elderly patient, rather than an increased sensitivity. On these grounds, age should be one of the criteria for selecting the appropriate dose of alfentanil.
研究了静脉注射50微克/千克阿芬太尼推注剂量在10例老年患者手术麻醉期间的临床效果，并与9例年轻成年人相同剂量的效果进行比较。在注射后的第一个小时内定期采集血浆样本以测定阿芬太尼浓度。心血管变化较小。两组在阿芬太尼给药后不久均出现收缩压短暂下降，但在老年患者中更为明显。所有患者术中初始镇痛质量良好。根据镇痛不足迹象的出现判断，50微克/千克阿芬太尼的作用持续时间在老年患者中（平均：36分钟）比年轻患者中（平均：22分钟）更长。这些时间点推算出的阿芬太尼血浆水平相似。因此，作用持续时间的差异必定是由于老年患者体内消除较慢，而非敏感性增加。基于这些理由，年龄应作为选择合适阿芬太尼剂量的标准之一。
