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目的 :探讨法洛四联症根治术患儿大剂量应用国产芬太尼的药代动力学。方法 :随机选择法洛四联症根治术患儿 8例 ,芬太尼 10 μg/kg静注后用微量泵持续输注 1μg/(kg·min)至切皮。用GC MS测定血浆芬太尼浓度 ,并计算药代动力学参数。结果 :芬太尼的药代动力学符合开放型三室模型 ,其快速分布半衰期 (t1/2 π)、缓慢分布半衰期 (t1/2 α)和消除半衰期 (t1/2 β)分别为 1.30 ,11.0和 373.5min。总清除率 (Cl)、表观分布容积 (Vd)和中心分布容积 (Vc)分别为 185 .6ml/min ,14.1L/kg和 12 .7L。结论 :法洛四联症患儿心内直视手术国产芬太尼t1/2 β及药物作用时间延长 ,增加手术后再发性呼吸抑制的发生率 ,应注意术后的呼吸管理。
Objective: To investigate the pharmacokinetics of domestic fentanyl for high-dose tetralogy of Fallot in children undergoing radical operation. Methods: Eight children were randomized to receive tetralogy of Fallot. After intravenous injection of 10 μg / kg of fentanyl, a continuous infusion of 1 μg / (kg · min) was injected into the skin of the peeled skin with a micropump. Plasma fentanyl concentrations were determined by GC MS and pharmacokinetic parameters were calculated. Results: The pharmacokinetics of fentanyl was in accordance with the open three-compartment model with fast distribution half-life (t1 / 2 π), slow distribution half-life (t1 / 2 α) and elimination half-life (t1 / 2 β) of 1.30, And 373.5 min. The total clearance (Cl), apparent volume of distribution (Vd) and central volume of distribution (Vc) were 185.6 ml / min, 14.1 L / kg and 12.7 L, respectively. Conclusion: The fentanyl t1 / 2 β in patients undergoing open heart surgery in tetralogy of Fallot prolongs the action time of drugs and increases the incidence of recurrent respiratory depression after surgery. Attention should be paid to postoperative respiratory management.