摘要
①目的探讨骨科患者应用国产芬太尼的药代动力学变化.②方法随机选择骨科下肢手术患者10例,男7例,女3例,年龄26～38岁.麻醉诱导气管插管后静脉注射芬太尼5μg/kg.在注射芬太尼前及注射后1、3、5、10、30、60、120、180和240分钟时点抽取血浆标本3mL,-20℃低温保存,待测.芬太尼测定采用气相色谱-质谱法.应用3P87药代动力学程序计算药代动力学参数.③结果注射芬太尼后血药浓度立刻达到 13.4ng/mL,并快速下降,在用药后60、120和240分钟时注药量的92.4%、94.1%和95.9%从血浆被清除.t1/2π、t1/2α和t1/2β依次为1.62分钟, 13.97分钟和238.97分钟,Vc、Vd 和Cl依次为(0.328±0.114)L/kg、(3.83±1.21)L/kg和(12.61±4.32)mL/(kg*min).④结论静脉注射芬太尼5μg/kg可持续镇痛达4小时以上,2、3小时的手术不必再追加芬太尼,也不会引起呼吸方面的问题.
Objective To study the pharmacokinitics of domestic fentanyl in patients undergoing orthopaedic surgery. Methods 10 patients undergoing orthopaedic surgery, the age of the patients ranged from 26 to 38 years. The plasma samples were obtained from radial artery 1,3,5,10,30,60,180 and 240min following a bolus injection of domestic fentanyl 5μg/kg. The plasma fentanyl level was determined by GC/MS and the pharmacokinitic parameters were calculated by use of 3p87 program. Results Plasma fentanyl concentration reached its peak rapidly following a bolus injection, and fell also rapidly and 92.4%, 94.1% and 95.9% of the＇ dose was eliminated from plasma in 60min, 120min and 240rain respectively. Three -compartment model was fitted to the pharmaeokinitic profile of fentanyl. The pharmacokinitie parameters obtained t1/2π, t1/2α and t1/2β were 1. 62min, 13.97min and 238.97rain respectively, Vc, Vd and Cl were （0. 328 ±0.114）L/kg, （3.83 ± 1.21 ）L/kg and （ 12. 61 ± 4.32） ml/kg·min respectively. Condusion The pharmaeokinities of domestic fentanyl in patients undergoing orthopaedic surgery was similar to that abdominal surgery, analgesic time following a bolus injection of domestic fentanyl 5μg/kg can lasted 4hr, and fentanyl should be not applied in lasting 2- 3hr surgery operation. The longer t1/2β and fluctuations in plasma concentration of fentanyl may contribute to prolonging and recurrent ventilatory effect.
出处
《华北煤炭医学院学报》
2005年第6期698-700,共3页
Journal of North China Coal Medical College
基金
河北省唐山市科技攻关课题:编号05134602a
关键词
芬太尼
骨科手术
药代动力学
Fentanyl
Orthopaedic surgery
Pharmacokinitics
作者简介
徐凯智（1958-），男，医学硕士，主任医师、教授，主要研究方向：心胸血管麻醉。
