CAJ | 학술논문

目的观察腹部外科手术患者国产舒芬太尼单次静脉注射的药代动力学特征.方法随机选择腹部外科手术患者10例,ASA Ⅰ、Ⅱ级,年龄51～65岁,体重58～68 kg.全身麻醉后经前臂一次性静脉注射国产舒芬太尼2 μg,于注药后1、3、5、10、20、30、60、120、180、240 min和360 min采集桡动脉抗凝全血3ml,离心后吸取血浆1 ml注入真空试管中,-80℃低温保存待测.用液相色谱-质谱联用法测定血浆舒芬太尼浓度,3P97药理学程序判别房室模型并计算药代动力学参数:中心分布容积(Vc),表观分布容积(Vd),快速分布半衰期(t1/2π)、缓慢分布半衰期(t1/2α)、排除半衰期(t1/2β),常数(P、A、B、π、α、β)和速率常数(k10、k12、k21、k13、k31)、清除率(CL)和血药浓度与时间曲线下面积(AUC)等.结果国产舒芬太尼在腹部手术患者的血药浓度与时间曲线可用三指数函数方程表示:Cp(t)=2.86e-0.8241t+0.75e-0.0604t+0.14e-0.0050t.主要药代动力学参数t1/2π=(1.29±0.81)min、t1/2α=(12.20±2.84)min,t1/2β=(150.50±48.71)min,Vc=(0.552±0.104)L/kg、Vd=(9.008±0.754)L/kg,CL=(0.044±0.011)L/(kg·min)和AUC=(47.58±11.88)ng/(ml·min).结论国产舒芬太尼在腹部外科手术患者的药代动力学符合三室开放模型,其药代动力学特征与其临床药理学特性相一致.
목적 관찰복부외과수술환자국산서분태니단차정맥주사적약대동역학특정.방법 수궤선택복부외과수술환자10례,ASA Ⅰ、Ⅱ급,년령51～65세,체중58～68 kg.전신마취후경전비일차성정맥주사국산서분태니2 μg,우주약후1、3、5、10、20、30、60、120、180、240 min화360 min채집뇨동맥항응전혈3ml,리심후흡취혈장1 ml주입진공시관중,-80℃저온보존대측.용액상색보-질보련용법측정혈장서분태니농도,3P97약이학정서판별방실모형병계산약대동역학삼수:중심분포용적(Vc),표관분포용적(Vd),쾌속분포반쇠기(t1/2π)、완만분포반쇠기(t1/2α)、배제반쇠기(t1/2β),상수(P、A、B、π、α、β)화속솔상수(k10、k12、k21、k13、k31)、청제솔(CL)화혈약농도여시간곡선하면적(AUC)등.결과 국산서분태니재복부수술환자적혈약농도여시간곡선가용삼지수함수방정표시:Cp(t)=2.86e-0.8241t+0.75e-0.0604t+0.14e-0.0050t.주요약대동역학삼수t1/2π=(1.29±0.81)min、t1/2α=(12.20±2.84)min,t1/2β=(150.50±48.71)min,Vc=(0.552±0.104)L/kg、Vd=(9.008±0.754)L/kg,CL=(0.044±0.011)L/(kg·min)화AUC=(47.58±11.88)ng/(ml·min).결론 국산서분태니재복부외과수술환자적약대동역학부합삼실개방모형,기약대동역학특정여기림상약이학특성상일치.
Objective To study pharmacokinetics of domestic sufentanil as a single intravenous injection in Chinese patients undergoing abdominal surgery. Methods Ten patients undergoing abdominal surgery, ASA Ⅰ-Ⅱ grade,age from 51 to 65 years old,weighing from 58～68 kg were studied. Intravenous and intra-arterial cannulae were placed in advance. After general anesthesia, sufentanil 2 μg/kg was administered as a rapid bolus intravenously. Blood samples were obtained at 1,3,5,10,20,30,60,120,180,240 and 360 min after sufentanil injection. Plasma was separated from blood samples immediately and stored at -80 ℃ until assayed. Plasma concentration of sufentanil were determined by liquid chromatography mass spectrometry, pharmacokinetic parameters were calculated by 3P97 pharmacology program:central volume of distribution(Vc), apparent volume of distribution (Vd), rapid distribution half-life(t1/2 π), slow distribution half-life(t1/2 α), terminal elimination half-life(t1/2 β),speed constant(P, A, B, π, α, β, k10, k12, k21, k13, k31), clearance(CL)and area under curve(AUC)and so on. Results Pharmacokinetics of sufentanil in patients ndergoing gastrectomy was best fitted to three-compartment open model,the tri-exponential equation :Cp(t)= 2. 86e-0.8241t + 0.75e-0.0604t + 0.14e-0.0050t. Main pharmacokinetic parameter t1/2π =(1.29 ± 0.81)min, t1/2α =(12.20 ± 2.84)min, t1/2β =(150.50 ±48.71)min,Vc =(0.552 ±0.104)L/kg,Vd =(9.008 ±0. 754)L/kg,CL =(0.044 ±0. 011)L/(kg · min)and AUC =(47.58 ±11.88)ng/(ml · min). Conclusions Pharmacokinetics of domestic sufentanil in patients undergoing abdominal surgery was best fitted to three-compartment open model, and the pharmacokinetic characteristics of sufentanil were consistent with its clinical pharmacology.