Lehmann K A, Gensior J, Daub D
Anaesthesist. 1982 Dec;31(12):655-9.
In 72 patients (ASA I-III) undergoing all kinds of elective surgery under routine neuroleptanalgesia, fentanyl plasma concentrations were determined at the moment of diminishing analgesic effect. Minimum analgesic blood concentrations were found to be approximately log-normally distributed (mean 2.89 ng/ml, c.v. 77.56%). There was no significant difference between sex, age or type of surgery. The finding contradict the common opinion that analgesic threshold concentrations exist or that pharmacodynamic effects of the receptor specific drug fentanyl could easily be predicted by blood pharmacokinetics. It is suggested that individual dosing of fentanyl rather than continuous infusion should be preferred in routine neuroleptanalgesia.
在72例（ASA I-III级）接受各种择期手术的患者中，在常规神经安定镇痛下，于镇痛效果减弱时测定芬太尼血浆浓度。发现最低镇痛血药浓度近似对数正态分布（均值2.89 ng/ml，变异系数77.56%）。性别、年龄或手术类型之间无显著差异。这一发现与存在镇痛阈浓度或受体特异性药物芬太尼的药效学效应可通过血药动力学轻易预测的普遍观点相矛盾。建议在常规神经安定镇痛中，应优先采用芬太尼个体化给药而非持续输注。
