TOXICITY OF BUPIVACAINE, WITH REFERENCE TO ITS METABOLITES

对4例ICU肝衰竭患者静脉注射吲哚菁绿（ICG）的药代动力学进行了研究。血清胆红素、氨气升高，意识水平为ⅱ~ⅲ级肝昏迷。静脉滴注ICG 0.5 mg/kg，高效液相色谱法测定其血清浓度。两室模型观察到清除率降低，分布半衰期升高，消除半衰期。隔室分析观察到平均居住时间延长，分布体积增加，清除率降低。双室模型更适合分析ICG的药代动力学，ICG的分布体积大于血浆体积，提示ICG在这些患者中分布到血管外空间。从这些结果来看，在药代动力学模型中，肝脏应该被认为是中心隔间，而不是外周隔间。

Pharmacokinetics of intravenously administered indocyanine green (ICG) was studied in 4 ICU patients with hepatic failure. Elevated serum bilirubin, anmonia was observed and their consciousness level was hepatic coma grade II-III.0.5 mg/kg ICG was intravenously administered and its serum concentration was measured by high performance liquid chromatography. Decreased clearance and elevated distribution half life, elimination half life was observed with two compartment model. Prolonged mean residential time, increased volume of distribution, decreased clearance was observed by compartment analysis. Two compartment model was more suitable for the analysis of pharmacokinetics of ICG, volume of distribution was expanded more than the volume of plasmsa, suggesting that ICG was distributed to the extravascular space in these patients. From these results, liver should be considered as the central compart, not as the peripheral compartment in the pharmacokinetic model.