肾移植术中舒芬太尼临床药动学研究

目的:研究肾移植术中舒芬太尼临床药动学。方法:对10例慢性肾功能衰竭择期拟行亲属供肾移植手术患者麻醉诱导时,外周静脉恒速泵注舒芬太尼1.0μg·kg-1,5min注射完毕;舒芬太尼给药前和给药后1、3、5、7、10、15、20、30、60、90、120min及之后每小时取桡动脉血标本直至手术结束。采用液-质联用(LC-MS)法测定患者血浆中舒芬太尼浓度,应用DAS软件计算舒芬太尼药动学参数。结果:患者肾移植术中舒芬太尼药动学可以用三房室模型描述,权重系数为1,其中t1/2α=(2.622±1.179)min,t1/2β=(17.283±13.652)min,t1/2γ=(87.469±68.66)min,V1=(0.253±0.062)L·kg-1,CL=(0.024±0.007)L·min-1·kg-1。结论:应用舒芬太尼临床常用剂量时,血药浓度在静脉注射后快速下降。肾移植患者术中舒芬太尼药动学符合三房室模型,消除半衰期不因为肾功能衰竭延长。

Clinical Pharmacokinetics of Sufentanil in Patients Undergoing Kidney Transplantation

OBJECTIVE: To study the clinical pharmacokinetics of sufentanil in patients undergoing kidney transplantation. METHODS: 10 patients with chronic renal failure scheduled for kidney transplantation were included in this study. Following induction of anesthesia each patient received sufentanil 1.0 μg·kg-1 by constant peripheral venous infusion in 5 min. Blood samples of sufentanil were obtained from the artery line at 1, 3, 5, 7, 10, 15, 20, 30, 60, 90, 120 min and hourly until the end of surgery. Sufentanil plasma concentrations were measured by LC-MS. The sufentanil pharmacokinetic parameters were computed by DAS. RESULTS: The pharmacokinetics of sufentanil in patients undergoing kidney transplantation could be described using three-compartment model with weight factor of 1. t1/2α=(2.622±1.179) min,t1/2β=(17.283±13.652) min, t1/2γ=(87.469±68.66) min, V1=(0.253±0.062) L·kg-1, CL=(0.024±0.007) L·min-1·kg-1. CONCLUSION: When conventional amount of sufentanil was used in the clinic, its plasma concentration decreased rapidly after intravenous injection. The pharmacokinetics of sufentanil in patients with kidney transplantation conforms to three-compartment model and t1/2γ of sufentanil will not be extended because of renal failure prolongation.