摘要
目的 观察老年手术病人丙泊酚单次静脉注射的药代动力学特征。方法 7例ASAⅠ～Ⅱ级、年龄 6 7～ 81岁的择期老年手术病人 ,经前臂静脉注射丙泊酚 1mg/kg ,分别于注射前和注射后 1、2、4、6、1 0、1 5、30、4 5、6 0、75、90、1 2 0、1 5 0、1 80、2 4 0、30 0、36 0min从右颈内静脉采血 3ml,肝素抗凝 ,离心后取上层血浆于 4℃下保存。用高效液相色谱荧光法检测血浆中丙泊酚浓度 ,3P87软件计算药代动力学参数。结果 7例老年病人丙泊酚的药代动力学特征均符合三室开放模型 ,快速分布半衰期 (T1 /2 pi)、中央室分布容积 (Vc)、分布速率常数 (K1 2 、K1 3 、K1 0 )、全身清除率 (CL)等值均与文献报道一致 ,缓慢分布半衰期 (T1 /2 α)、消除半衰期 (T1 /2 β)则较短。与文献报道中的成人值相比 ,Vc和CL较低。结论 丙泊酚用于老年人麻醉具有起效快、维持时间短、恢复迅速的特点 ,但体内Vc较小 ,CL减慢 ,故临床用药时需参考年龄因素减少剂量 ,减轻不良反应和防止药物蓄积。
Objective To investigate the pharmacokinetic profile of propofol with single bolus intravenous injection in elderly patients. Methods In 7 elderly patients aged 67 81 undergoing selective surgical procedures,ASA grade Ⅰ Ⅱ,a single bolus dose of propofol 1 mg/kg was injected via a forearm vein. From right internal jugular vein,3 ml blood sample was taken for whole blood propofol estimation before injection,and after the end of the propofol injection at the following timepoints: 1,2,4,6,10,15,30,45,60,75,90,120,150,180,240,300 and 360 min. Each sample was thoroughly mixed in tubes containing liquaemin sodium,then centrifuged,the plasma was removed and stored in refrigerator at 4 ℃. Propofol concentrations of plasma were determined by high performance liquid chromatography with fluorescence detection. Pharmacokinetic analysis was performed using 3P87 programe. Results Pharmacokintics of propofol in 7 elderly patients were best described by a three compartment pharmacokinetic model. The pharmacokinetic parameters including T 1/2 pi (1 5 min,Vc (0 1076 L/kg),K 12 (0 2085 min 1 ),K 13 (0 0866 min 1 ),K 10 (0 1368 min 1 ),CL (0 0142 L·kg 1 ·min 1 ) were similar to those described by the other authors,but T 1/2 α (15 8 min) and T 1/2 β (148 3 min) were shorter. Vc and CL were lower in the elderly compared with those in adult patients reported by the others. Conclusions Propofol has the characteristics of fast onset and short duration of action and rapid recovery when used for anesthesia induction in elderly patients. Because Vc and CL were decreased, the propofol requirements must be reduced in the elderly in order to relieve the side effects and to prevent accumulations.
出处
《临床麻醉学杂志》
CAS
CSCD
2003年第10期585-587,共3页
Journal of Clinical Anesthesiology
