Ludbrook G L, Upton R N, Grant C, Gray E C
Dept of Anaesthesia and Intensive Care, Royal Adelaide Hospital, South Australia.
Anaesth Intensive Care. 1996 Aug;24(4):445-52. doi: 10.1177/0310057X9602400406.
The time-course of propofol concentrations in the blood and brain following rapid administration of three doses were examined using a sheep preparation and regional pharmacokinetic techniques. These were compared to the time-course of cerebral effects of propofol reported previously. There were marked differences between the time-course of propofol concentrations in arterial blood and the brain, with a close relationship between the time-course of brain concentrations and effects on depth of anaesthesia and CBF. There was evidence that the effect of propofol on cerebral blood flow altered its own rate of elution from the brain. Hysteresis between arterial propofol concentrations and cerebral effects following rapid i.v. administration therefore appears to have a pharmacokinetic basis, and conventional compartmental pharmacokinetic analysis using blood concentrations alone may fail to accurately predict the time-course of both brain propofol concentrations and depth of anaesthesia.
使用绵羊实验模型和区域药代动力学技术,研究了快速给予三剂异丙酚后血液和大脑中异丙酚浓度的时间进程。将这些结果与先前报道的异丙酚脑效应的时间进程进行了比较。动脉血和大脑中异丙酚浓度的时间进程存在显著差异,大脑浓度的时间进程与对麻醉深度和脑血流量的影响密切相关。有证据表明,异丙酚对脑血流量的影响改变了其自身从大脑中洗脱的速率。因此,快速静脉注射后动脉异丙酚浓度与脑效应之间的滞后现象似乎具有药代动力学基础,仅使用血液浓度的传统房室药代动力学分析可能无法准确预测脑异丙酚浓度和麻醉深度的时间进程。