Pharmacokinetic model-driven infusion of fentanyl in children
Pharmacokinetic model-driven infusion of fentanyl in children
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DOI：
10.1097/00000542-199612000-00007
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发表时间：
1996-12-01
期刊：
影响因子：
8.8
通讯作者：
Shafer, SL
中科院分区：
文献类型：
--
作者：
Ginsberg, B;Howell, S;Shafer, SL
背景资料：本研究确定了以前定义的成人芬太尼药代动力学在儿童手术的准确性，从这个人口，芬太尼的药代动力学的特点是在儿童通过计算机辅助连续输液device.Methods：20岁之间的2.7和11岁的儿童进行择期非心脏手术。诱导后，用60%氧化亚氮的氧气补充芬太尼（n = 10）或芬太尼加异氟烷（n = 10）维持麻醉，芬太尼通过计算机辅助连续输注给药至临床要求确定的目标浓度，测定血浆芬太尼浓度，并用于评价芬太尼药代动力学的性能，然后确定一组新的药代动力学参数和这些patients.Results模拟的上下文敏感的半衰期中的方差：原来的成人芬太尼药代动力学导致正偏差（10.4%），表明测量的浓度大多大于预测。以年龄和体重为协变量的三房室模型提供了最佳药代动力学参数。这些导致在剩余的性能误差为-1.1%和17.4%的中位绝对性能误差，从这个儿科人群确定的上下文敏感的时间仅仅比以前发表的上下文敏感的时间adultes.Conclusions：芬太尼的药代动力学计算机辅助连续输注管理成人和儿童之间的不同。新推导的参数可能更适合于确定2至11岁儿童的输液方案，最长可达4小时。
Background: This study determined the accuracy of previously defined adult fentanyl pharmacokinetics in children having surgery; from this population, the pharmacokinetics of fentanyl were characterized in children when administered via a computerized assisted continuous-infusion device.Methods: Twenty children between the ages of 2.7 and 11 y scheduled to undergo elective noncardiac surgery were studied. After induction, anesthesia was maintained with 60% nitrous oxide in oxygen supplemented with fentanyl (n = 10) or fentanyl plus isoflurane (n = 10), Fentanyl was administered via computerized assisted continuous-infusion to target concentrations determined by clinical requirements, Plasma fentanyl concentrations were measured and used to evaluate the performance of the fentanyl pharmacokinetics and then to determine a new set of pharmacokinetic parameters and the variance in the context-sensitive half-times simulated for these patients.Results: The original adult fentanyl pharmacokinetics resulted in a positive bias (10.4%), indicating that measured concentrations were mostly greater than predicted. A tno-compartment model with age and weight as covariates provided the optimal pharmacokinetic parameters. These resulted in a residual performance error of -1.1% and a median absolute performance error of 17.4%, The context-sensitive times determined from this pediatric population mere considerably shorter than the context-sensitive times previously published for adults.Conclusions: The pharmacokinetics of fentanyl administered by computerized assisted continuous-infusion differ between adults and children. The newly derived parameters are probably more suitable to determine infusion schemes of up to 4 h in children between the ages of 2 and 11 y.