芬太尼对异丙酚静脉麻醉药代动力学和药效学的影响  

Effects of fentanyl on pharmacokinetics and pharmacodynamics of propofol during total intravenous anesthesia

作　　者：杨威[1] 郑方[1] 李文志[1] 周少鹏[1] 李德辉[1] 李继庆 

机构地区：[1]哈尔滨医科大学附属第二医院麻醉科,150086

出　　处：《中华麻醉学杂志》1999年第12期708-710,共3页Chinese Journal of Anesthesiology

摘　　要：目的探讨芬太尼对异丙酚静脉麻醉药代动力学和药效学的影响。方法 ２０例开胸手术患者随机分为异丙酚复合芬太尼静脉麻醉组（Ａ组，ｎ＝１０），异丙酚静脉麻醉复合胸段硬膜外阻滞组（Ｂ组，ｎ＝１０）。测定术中和术后病人异丙酚血清浓度，记录意识消失、术后睁眼和定向时间及术后行为评分。结果 Ａ组消除相药代动力学参数Ｔ_１／２β、ＭＲＴ、ＡＵＣ显著高于 Ｂ组（Ｐ＜０． ０５或 ０．０１），Ａ组ＣＬ显著低于Ｂ组（Ｐ＜０． ０１）。 Ａ组术后唤醒、定向时间均长于Ｂ组（Ｐ＜０． ０５）。 Ａ组术后３０分钟遗忘、定向、合作评分均不同程度高于Ｂ组（Ｐ＜０．０５）。结论芬太尼可延缓异丙酚消除相代谢，延迟术后苏醒过程。芬太尼与异丙酚复合静脉麻醉是合理的给药方案。Objective To assess the effects of fentanyl on pharmacokinetics and pharmacodynamics of propofol during total intravenous anesthesia. Methods Twenty patients, scheduled for thoracic surgery, were randomly assigned to two groups: fentanyl combined with propofol intravenous anesthesia (group A, n=10), and thoracic epidural block combined propofol intravenous anesthesia (group B, n=10). The serum concentrations of propofol were measured with high performance liquid chromatography, the unconscious time and recovery time were recorded and postoperative performances were scored. Results T_1/2β, MRT and AUC in group A were significantly higher and CL was significantly lower than those in group B (P<0. 05 or 0.01). The recovery time was much longer and the performance scores at 30th min of postoperation were markedly higher in group A than those in group B (P<0.05). Conclusion in terminal phase, fentanyl slowes down the elimination of propofol to make the recovery time longer,and with synergistic effect, the combination of fentanyl and propofol intravenous anesthesia is an optimal infusion regimen.

关 键 词：芬太尼 二异丙酚 麻醉 药代动力学 药效学 

分 类 号：R971.2[医药卫生—药品] R969.1[医药卫生—药学]