Petros A, Dunne N, Mehta R, Doré C J, Van Peer A, Gillbe C, Macrae D
Department of Anaesthesia and Intensive Care, Royal Brompton, National Heart and Lung Hospital, London, United Kingdom.
Anesth Analg. 1995 Sep;81(3):458-64. doi: 10.1097/00000539-199509000-00005.
The pharmacokinetics of alfentanil were studied after two different methods of cardiopulmonary bypass (CPB) which used either a normothermic technique or a hypothermic technique with body temperatures below 30 degrees C. A group of surgical patients who did not undergo CPB were also studied. All patients (n = 36) received alfentanil 50 micrograms/kg as a rapid infusion over 10 min and plasma levels were measured for the following 8 h. The volume of distribution in steady state (Vdss) and the volume of central compartment (Vc) were significantly greater in the CPB groups (P = 0.009 and P = 0.04), compared to the nonbypass group. However, the elimination half-life of alfentanil (t1/2 beta) (mean, 95% confidence interval) did not differ significantly between the normothermic (134 min, range 104-172), hypothermic (143 min, range 111-184), and nonbypass (111 min, range 86-142) groups. Between the normothermic and hypothermic CPB groups no significant differences in Vdss, rate of clearance (Cl), or t1/2 beta were found. The pharmacokinetics of alfentanil showed fewer changes after CPB in this study than have been reported previously. Furthermore, different temperature management protocols during CPB did not influence alfentanil elimination.
研究了两种不同的体外循环（CPB）方法（一种是常温技术，另一种是体温低于30摄氏度的低温技术）后阿芬太尼的药代动力学。还研究了一组未接受CPB的外科患者。所有患者（n = 36）均在10分钟内快速输注50微克/千克阿芬太尼，并在接下来的8小时内测量血浆水平。与非体外循环组相比，体外循环组的稳态分布容积（Vdss）和中央室容积（Vc）显著更大（P = 0.009和P = 0.04）。然而，常温组（134分钟，范围104 - 172）、低温组（143分钟，范围111 - 184）和非体外循环组（111分钟，范围86 - 142）之间阿芬太尼的消除半衰期（t1/2β）（平均值，95%置信区间）没有显著差异。在常温体外循环组和低温体外循环组之间，未发现Vdss、清除率（Cl）或t1/2β有显著差异。在本研究中，阿芬太尼的药代动力学变化比之前报道的要少。此外，体外循环期间不同的温度管理方案并未影响阿芬太尼的消除。
