舒芬太尼在颅脑外伤患者中的药代动力学及对颅内压的影响
Pharmacokinetics and effects on intracranial pressure of sufentanil in head trauma patients.
作者信息
Scholz J, Bause H, Schulz M, Klotz U, Krishna D R, Pohl S, Schulte am Esch J
机构信息
Department of Anaesthesiology, University of Hamburg, University Hospital Eppendorf, Germany.
出版信息
Br J Clin Pharmacol. 1994 Oct;38(4):369-72. doi: 10.1111/j.1365-2125.1994.tb04368.x.
Ten patients with head trauma received an intravenous bolus of sufentanil (2 micrograms kg-1) followed at 30 min by infusion of sufentanil (median 150 micrograms h-1) and midazolam (median 9.0 mg h-1) over 48 h. Median (range) values of pharmacokinetic parameters for sufentanil were: t1/2,z = 16 (7-49) h; CL = 1215 (519-2550) ml min-1; CLR = 7 (2-38) ml min-1; Vss = 10.0 (6.8-24.2) 1 kg-1. Decreases in intracranial pressure (ICP) (from 16.1 +/- 1.7 to 10.8 +/- 1.3 mm Hg; P < 0.05) and mean arterial blood pressure (MAP) (from 85.5 +/- 3.9 to 80.2 +/- 4.9 mm Hg; P < 0.05) were observed within 15 min of the bolus injection of sufentanil and remained unchanged thereafter. Thus, cerebral perfusion pressure (CPP = MAP-ICP) was stable.
10名头部创伤患者静脉注射舒芬太尼（2微克/千克），30分钟后开始在48小时内输注舒芬太尼（中位数150微克/小时）和咪达唑仑（中位数9.0毫克/小时）。舒芬太尼药代动力学参数的中位数（范围）值为：t1/2,z = 16（7 - 49）小时；CL = 1215（519 - 2550）毫升/分钟；CLR = 7（2 - 38）毫升/分钟；Vss = 10.0（6.8 - 24.2）升/千克。在静脉注射舒芬太尼后15分钟内观察到颅内压（ICP）降低（从16.1±1.7降至10.8±1.3毫米汞柱；P < 0.05）和平均动脉血压（MAP）降低（从85.5±3.9降至80.2±4.9毫米汞柱；P < 0.05），此后保持不变。因此，脑灌注压（CPP = MAP - ICP）稳定。
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