Xue F, Sun B, Zou Q, Luo L
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing.
Chin Med J (Engl). 1996 Mar;109(3):233-7.
To evaluate the effects of 1 MAC of enflurane or isoflurane anesthesia on the pharmacokinetics of pancuronium.
Eighteen adult patients undergoing the elective plastic surgery were randomly divided equally into 3 groups, namely, Group 1 (control group), Group 2 (enflurane group) and Group 3 (isoflurane group). Anesthesia was maintained with thiopental and 67% N2O-O2 in Group 1, 1 MAC enflurane in Group 2 and 1 MAC isoflurane in Group 3. After administration of a bolus of pancuronium 100 micrograms/kg, an improved fluorimetric assay was used to determine the serum concentrations of pancuronium and the pharmacokinetic variables of pancuronium were calculated with a 3P87 program.
The disposition of pancuronium may be well described mathematically by a two-compartment open model. The results showed that in comparison with the control group, patients in Group 2 and Group 3 had a longer T1/2 beta and MRT. The patients in Group 2 had the slower K10 and lower CL than those in the control group. There were no significant differences among the three groups in T1/2 alpha, V1, V2, Vdss, V beta, K21, K12 and AUC.
During enflurane and isoflurane anesthesia, CL of pancuronium decreased, and T1/2 beta and MRT of pancuronium were prolonged in our patients, so duration of the effective plasma concentrations of pancuronium was much longer. As a result, the effects of enflurane and isoflurane of the pharmacokinetics of pancuronium may be part of reason why two drugs extended the duration of neuromuscular depression produced by pancuronium.
评估1个最低肺泡有效浓度（MAC）的恩氟烷或异氟烷麻醉对泮库溴铵药代动力学的影响。
18例择期行整形手术的成年患者被随机均分为3组，即第1组（对照组）、第2组（恩氟烷组）和第3组（异氟烷组）。第1组用硫喷妥钠和67%的N₂O - O₂维持麻醉，第2组用1个MAC的恩氟烷维持麻醉，第3组用1个MAC的异氟烷维持麻醉。静脉注射100微克/千克泮库溴铵后，采用改良荧光分析法测定泮库溴铵的血清浓度，并使用3P87程序计算泮库溴铵的药代动力学变量。
泮库溴铵的处置可用二室开放模型很好地进行数学描述。结果显示，与对照组相比，第2组和第3组患者的β相半衰期（T1/2β）和平均滞留时间（MRT）更长。第2组患者的药物从中央室向周边室的转运速率常数（K10）比对照组慢，清除率（CL）比对照组低。3组间的α相半衰期（T1/2α）、中央室分布容积（V1）、周边室分布容积（V2）、稳态分布容积（Vdss）、β相分布容积（Vβ）、药物从周边室向中央室的转运速率常数（K21）、药物从中央室向周边室的转运速率常数（K12）和药时曲线下面积（AUC）无显著差异。
在恩氟烷和异氟烷麻醉期间，泮库溴铵的清除率降低，泮库溴铵的T1/2β和MRT延长，因此泮库溴铵有效血药浓度的持续时间延长。因此，恩氟烷和异氟烷对泮库溴铵药代动力学的影响可能是这两种药物延长泮库溴铵所致神经肌肉阻滞持续时间的部分原因。
