非房室模型统计矩方法测定妊娠晚期孕妇瑞芬太尼的药代动力学特点

目的计算妊娠晚期孕妇瑞芬太尼的药代动力学参数并分析其药代动力学特点。方法妊娠晚期行剖宫产手术孕妇10例，于硬膜外麻醉成功后静脉注射瑞芬太尼1μg／kg，于给药后1、2、3、5、7、10、20min分别采集孕妇动脉血2．0ml，采用液一液萃取毛细管气相色谱质谱法测定瑞芬太尼血药浓度，以非房室模型的统计矩方法测定妊娠晚期孕妇瑞芬太尼药代动力学参数分并析其药代动力学特点。结果此方法测定的妊娠晚期孕妇瑞芬太尼药代动力学特点为非房室模型，其药代动力学参数：t1/2（2．85±0．18）min，血浆药物浓度一时间曲线面积（AUC）：（0—20min）、（16．17±0．55）min·ng／ml，平均滞流时间（MRT）：（5．02±0．22）min，中央清除率（CL）：（59．99±2．17）ml·min^-1·kg^-1，建立在血浆药物浓度基础上的稳定表现分布表现容积（VSS）：（300．96±8．20）ml／kg。结论妊娠晚期孕妇其特殊的血液循环系统的改变，使瑞芬太尼在其体内清除率增高，消除半衰期延长。

Detection of pharmacokinetics of remifentanil at late trimester of pregnancy by using Rosenblueth method of non compartment model

Objective To calculate the pharmacokinetic parameters of remifentanil in pregnant women at late trimester of pregnancy,and to analyze the pharmacokinetic characteristics of remifentanil. Methods 10 ASA I pregnant women at late trimester of pregnancy who underwent elective cesarean section under epidural anesthesia,were injected with remifentanil 1 μg/kg by intravenous injection after epidural anesthesia. The maternal arterial blood samples 2.0 ml were taken at 1,2,3,5,7,10,20 min after drug administration. The liquid-liquid extraction and capillary GC-MS-SIM were used to detect the concentration of remifentanil. Rosenblueth method of non compartment model was used to calculate the pharmacokinetic parameters of remifentanil and to analyze the pharmacokinetic characteristics of remifentanil. Results The pharmacokinetic characteristics of remifentanil in pregnant women at late trimester of pregnancy tested by Rosenblueth method were non Compartment model. Pharmacokinetic parameters were as follows ： t1/2 ： （ 2.85 ± 0. 18 ） min, AUC （ 0 - 20min ） ： （ 16. 17 ± 0. 55 ） min · ng/ml MRT： （ 5.02 ± 0.22 ） min, CL： （ 59.99 ± 2. 17 ） ml · min^ - 1 · kg^- 1, VSS： （ 300.96 ± 8.20 ） ml/kg. Conclusion The pharmacokinetic characteristics of remifentanil in pregnant women at late trimester of pregnancy are longer half-time and higher clearance rate.