异丙酚静脉麻醉期间利多卡因临床药动学  被引量:1

Pharmacokinetics of lidocaine in total intravenous anesthesia with propofol

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作  者:张兴安[1] 肖彬[1] 赵高峰 吴群林[1] 徐波[1] 王捷[3] 施冲[1] 

机构地区:[1]广州军区广州总医院麻醉科,广州510010 [2]广州中医药大学第二附属医院麻醉科,广州510120 [3]广州军区广州总医院医学实验科,广州510010

出  处:《中国临床药学杂志》2007年第5期272-275,共4页Chinese Journal of Clinical Pharmacy

基  金:广东省科技推广成果应用项目(2002C40401);广州市科技计划项目(2005C13G0101)

摘  要:目的研究异丙酚靶控输注静脉全麻下恒速输注不同速率利多卡因时机体吸收、分布、代谢情况。方法选择18例异丙酚静脉全麻手术患者,麻醉稳定后随机输注利多卡因0.15 mg·kg^(-1)·min^(-1)(组Ⅰ,n=9)或0.20 mg·kg^(-1)·min^(-1)(组Ⅱ,n=9)。利多卡因注药后和停药后不同时间分别抽取桡动脉血,应用HPLC-UV法检测利多卡因血浆浓度,DAS软件包计算药动学参数。结果利多卡因注射后血药浓度-时间曲线可用开放性二室模型描述,2组患者利多卡因药动学参数除AUC_((0-65))外差异均无统计学意义(P·0.05):t_(1/2α)为(2.701±2.346)min,t_(1/2β)为(53.508±25.111)min,V_1/F为(0.251±0.151)L·kg^(-1),EL为(6.704±5.098)mL·min^(-1)·kg^(-1),k_(10)为(0.019±0.005)·min^(-1),k_(12)为(0.038±0.023)·min^(-1),k_(21)为(0.195±0.158)·min^(-1)。t_(1/2α)、t_(1/2β)、V_1、CL、k_(10)、k_(12)、k_(21)的RSD分别为86.85%、46.93%、60.10%、76.04%、26.07%、60.55%和80.80%。结论临床应用利多卡因不同输注速率对药动学无明显影响。与异丙酚联合用于全麻患者时利多卡因参数个体差异较大,静脉麻醉靶控输注时应注意个体化用药。AIM To investigate the pharmacokinetics of lidocaine during general anesthesia with target controlled infusion of propofol. METHODS Eighteen patients under general anesthesia with lidocaine and propofol were randomly divided into 2 groups. The patients received lidocaine by constant-rate infusion of 0.15 mg· kg^-1. min^-1(groupⅠ, n = 9) or 0.20 mg·kg^-1 ·min^-1(groupⅡ, n =9) respectively. The radial artery blood samples were obtained after infusion and after stopping infusion. The plasma lidocaine concentrations were determined by HPLC with ultraviolet detection(HPLC-UV). Phamacokinetic analysis was performed using drug and statistics (DAS) program. RESULTS The pharmacokintics of lidocaine in 2 groups were best described by a two compartment pharmacokinetic model. There were no significant differences for the pharmacokinetic parameters between 2 groups except AUC(0- 65)( P 〉 0.05). The pharmacokinetic parameters were as follows: t1/2α(2.701 ± 2.346)min, t1/2β(53.508 ± 25.111) min, V1/F(0.251 ± 0. 151) L· kg^-1, CL (6.704 ± 5.098) mL· min^-1·kg^-1, k10(0.019 ± 0.005) ·min^-1, k12(0.038 ± 0.023) ·min^-1, k21(0. 195 ± 0. 158) ·min^-1, The RSD of t1/2α ,t 1/2β, V1,CL, k 10, k12, k 21 was 86.85%, 46.93%, 60.10%, 76.04%, 26.07%, 60.55% and 80.80%, respectively. CONCLUSION The different constant-rate infusion has not influence on the pharmacokinetics of lidocaine (P 〉 0.05). The RSD of phamcokinetics of lidocaine has significant individual difference during the general anesthesia combined with propofol. The target plasma concentration of lidocaine should be prescribed individually.

关 键 词:利多卡因 临床药动学 异丙酚 静脉内麻醉 靶控输注 

分 类 号:R96[医药卫生—药理学]

 

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