Weekes L M, Keneally J P, Goonetilleke P H, Ramzan I M
Department of Pharmacy, University of Sydney, New South Wales, Australia.
Paediatr Anaesth. 1995;5(6):369-74. doi: 10.1111/j.1460-9592.1995.tb00329.x.
The aim of this study was to determine the pharmacokinetic parameters for alcuronium in children with cyanotic or acyanotic congenital cardiac disease undergoing cardiopulmonary bypass surgery and to compare these parameters with previously reported values in children and adults with normal cardiac function. Seven children with acyanotic disease and seven with cyanotic disease were studied. Alcuronium (base) was administered in an initial dosage of 0.25 mg.kg-1 with additional doses as needed to maintain paralysis. Using time averaged data, cyanotic children had lower mean clearance, elimination half-life and volume of distribution at steady state than the acyanotic children; none of these differences was, however, statistically significant. In this study, children with acyanotic and cyanotic cardiac disease undergoing bypass, had a diminished clearance (P < 0.05) and a smaller volume of distribution (P < 0.05) than normal children and a shorter elimination half-life (P < 0.05) than adults. Onset of cardiopulmonary bypass caused an immediate marked decrease in alcuronium plasma concentrations which remained low in the acyanotic children at the completion of bypass.
本研究的目的是确定接受体外循环手术的患紫绀型或非紫绀型先天性心脏病儿童中阿库氯铵的药代动力学参数，并将这些参数与先前报道的心脏功能正常的儿童和成人的值进行比较。研究了7名患非紫绀型疾病的儿童和7名患紫绀型疾病的儿童。阿库氯铵（碱）的初始剂量为0.25mg·kg-1，根据需要追加剂量以维持麻痹状态。使用时间平均数据，紫绀型儿童的平均清除率、消除半衰期和稳态分布容积低于非紫绀型儿童；然而，这些差异均无统计学意义。在本研究中，接受体外循环的患非紫绀型和紫绀型心脏病的儿童，其清除率（P<0.05）和分布容积（P<0.05）低于正常儿童，消除半衰期（P<0.05）短于成人。体外循环开始导致阿库氯铵血浆浓度立即显著下降，在体外循环结束时，非紫绀型儿童的血浆浓度仍较低。
