老年与青壮年瑞芬太尼药代动力学差异比较  

The difference of pharmacokinetics of remifentanil between the elderly and adults

作　　者：谷志杰 张满和[2] 周秀敏[2] 赵会清 

机构地区：[1]河北省乐亭县医院麻醉科,063600 [2]河北省唐山工人医院 [3]河北省乐亭县医院保健科,063600

出　　处：《河北医药》2011年第2期172-173,共2页Hebei Medical Journal

摘　　要：目的探讨老年与青壮年手术患者瑞芬太尼药代动力学参数差异。方法 ASAⅠ或Ⅱ级择期全麻老年及青壮年患者各8例,老年患者年龄62～81岁,青壮年患者年龄18～60岁,全麻诱导时静脉注射瑞芬太尼5μg/kg,于瑞芬太尼注射后1、2、3、5、7、10、15、20、25、30、45、60min分别采集动脉血1.0ml。采用液-液萃取毛细管气相色谱质谱法测定瑞芬太尼血药浓度。结果老年及青壮年患者主要药代动力学参数分别为:t1/2β:(20±9)min、(12±7)min,表现分布容积:(56±17)L、(44±10)L,血浆清除率:(2.7±0.4)L/min、(4.0±0.5)L/min。结论老年与青壮年患者瑞芬太尼药代动力学均符合二房室模型,消除半衰期、表观分布容积、清除率二者明显不同,提示老年与青壮年患者间瑞芬太尼群体药代动力学可能存在差异。Objective To investigate and compare the pharmacokinetic parameters of remifentanil between the elderly and adults.Methods The eight elders and eight adults with ASA ⅠorⅡ patients undergoing elective operation under general anestesia,who were infused with remifentanil 5μg/kg during induction.The arterial blood samples （1.0 ml） were taken at 1,2,3,5,7,10,15,20,25,30,45,60 min after administration.The liquid-liquid extraction and capillary GC-MS-SIM was used to detect the concentration of remifentanil.Results The pharmacokinetics profile of remifentanil in the elderly and adults were best described by the two compartment model.The main pharmacokinetic parameters were t1/2β：（20±9）min （12±7）min,Vd：（56±17）L （44±10）L,CL （2.7±0.45）L/min （4.0±0.5）L/min.Conclusion The elimination half-time,the volume distribution and clearance in the elderly are significantly different from those of adults,which suggests that there may be some differences in pharmacokinetics of remifentanil between the elderly and adults.

关 键 词：瑞芬太尼 老年 青壮年 药代动力学 

分 类 号：R917.1[医药卫生—药物分析学]