Bozkurt P, Kaya G, Süzer O, Sentürk H
Istanbul University Cerrahpasa Medical Faculty, Department of Anesthesiology, Turkey.
Middle East J Anaesthesiol. 1996 Feb;13(4):405-13.
Sedative effects and drug elimination characteristics after intravenous bolus administration of diazepam 0.15 mg/kg were investigated in 15 patients with liver disease (Group I), and in 15 normal patients (Group II) during diagnostic laparoscopy. Diazepam induced heavier sedation in patients with liver disease (P < 0.02). Serum concentration of diazepam 30 minutes after administration was significantly lower in Group I (group with liver disease) when compared with Group II (control group) (210.68 +/- 112.65 ng/ml vs 451.57 +/- 239.87 ng/ml, p < 0.02). The sedation scores during the laparoscopy procedures correlate negatively with serum benzodiazepine levels. The benzodiazepine concentration-time profiles of the groups vary significantly (p < 0.02). Heavier sedative effect and lower benzodiazepine concentrations in patients with liver diseases suggests that the permeability of blood brain barrier increases and that higher affinity to benzodiazepine receptors exists. Differences in concentration-time courses of diazepam in patients with liver diseases is a warning indicating the accumulation of the drug when infused or used frequently.
在诊断性腹腔镜检查期间，对15例肝病患者（I组）和15例正常患者（II组）静脉推注0.15mg/kg地西泮后的镇静效果和药物消除特征进行了研究。地西泮在肝病患者中诱导的镇静作用更强（P<0.02）。给药30分钟后，I组（肝病组）的地西泮血清浓度显著低于II组（对照组）（210.68±112.65ng/ml对451.57±239.87ng/ml，p<0.02）。腹腔镜检查过程中的镇静评分与血清苯二氮䓬水平呈负相关。两组的苯二氮䓬浓度-时间曲线差异显著（p<0.02）。肝病患者更强的镇静作用和更低的苯二氮䓬浓度表明血脑屏障通透性增加，且对苯二氮䓬受体的亲和力更高。肝病患者地西泮浓度-时间过程的差异是一个警示，表明频繁输注或使用该药物时会发生药物蓄积。
