Hu O Y, Ho S T, Wang J J, Ho W, Wang H J, Lin C Y
School of Pharmacy, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Crit Care Med. 1993 Apr;21(4):527-31. doi: 10.1097/00003246-199304000-00012.
The aim of this study was to evaluate the possible effect of a severe burn on gastric emptying by determining the absorption kinetics of orally administered acetaminophen.
A prospective, controlled study.
A ten-bed burn center in a 1,300-bed university hospital.
Ten adult patients suffering from second-degree burn involving > 20% of total body surface area and 20 normal, healthy volunteers who acted as controls.
Patients received routine treatment such as nutritional support and cimetidine. However, opiates were stopped for at least 12 hrs before the start of the study, and nonsteroidal anti-inflammatory drugs as alternatives were used. After an 8-hr fast, the subjects ingested 0.5 g acetaminophen with 200 mL of water. The plasma concentrations of acetaminophen were determined by high-performance liquid chromatography, and the absorption kinetics was estimated from determination of time to reach the maximum plasma concentration, the maximum plasma concentration, and the area under the plasma concentration-time curve.
The mean time for reaching the maximum plasma concentration was 33 +/- 24 (SD) mins in patients and 39 +/- 24 mins in the healthy volunteers. The mean area under the plasma concentration-time curve from time 0 to 120 mins and the mean maximum plasma concentration were 556 +/- 190 micrograms/mL/min and 9.5 +/- 3.5 micrograms/mL in patients, and 539 +/- 131 micrograms/mL/min and 7.8 +/- 2.8 micrograms/mL in volunteers, respectively. There was no statistical difference between groups in the time to reach the maximum plasma concentration, the area under the plasma concentration-time curve from time 0 to 120 mins, and the maximum plasma concentration. The time for reaching the maximum plasma concentration was not correlated with the severity of the burn (% area of burn) and the duration of healing (days) after burn.
We conclude that severe burn injury does not affect the kinetics of gastric emptying, and that 200 mL of water ingested 2 hrs before anesthesia is quite safe in severely burned patients. Also, the absorption kinetics of acetaminophen was not altered by burn injury.
本研究旨在通过测定口服对乙酰氨基酚的吸收动力学，评估严重烧伤对胃排空的可能影响。
一项前瞻性对照研究。
一所拥有1300张床位的大学医院中的一个有十张床位的烧伤中心。
十名成年患者，二度烧伤面积超过体表面积的20%，以及20名正常健康志愿者作为对照。
患者接受营养支持和西咪替丁等常规治疗。然而，在研究开始前至少12小时停用阿片类药物，并使用非甾体类抗炎药作为替代。禁食8小时后，受试者用200毫升水服用0.5克对乙酰氨基酚。通过高效液相色谱法测定对乙酰氨基酚的血浆浓度，并根据达到最大血浆浓度的时间、最大血浆浓度以及血浆浓度-时间曲线下面积的测定来估计吸收动力学。
患者达到最大血浆浓度的平均时间为33±24（标准差）分钟，健康志愿者为39±24分钟。患者从0至120分钟的血浆浓度-时间曲线下平均面积以及平均最大血浆浓度分别为556±190微克/毫升/分钟和9.5±3.5微克/毫升，志愿者分别为539±131微克/毫升/分钟和7.8±2.8微克/毫升。在达到最大血浆浓度的时间、从0至120分钟的血浆浓度-时间曲线下面积以及最大血浆浓度方面，两组之间无统计学差异。达到最大血浆浓度的时间与烧伤严重程度（烧伤面积百分比）和烧伤后愈合时间（天数）无关。
我们得出结论，严重烧伤不会影响胃排空动力学，并且在严重烧伤患者中，麻醉前2小时摄入200毫升水是相当安全的。此外，烧伤并未改变对乙酰氨基酚的吸收动力学。
