TOXICITY OF BUPIVACAINE, WITH REFERENCE TO ITS METABOLITES

对4例重症监护病房（ICU）肝衰竭患者静脉注射吲哚菁绿色（ICG）的药代动力学进行了研究。观察到血清胆红素升高、贫血，意识水平为肝昏迷II~III级。静脉注射ICG 0. 5 mg/kg，用高效液相色谱法测定其血清浓度。采用二室模型观察药物清除率降低，分布半衰期和消除半衰期延长。房室分析显示平均滞留时间延长，分布容积增加，清除率降低。二室模型更适合ICG的药代动力学分析，分布容积较血浆容积扩大，提示ICG在这些患者体内分布于血管外空间。根据这些结果，在药代动力学模型中，肝脏应被视为中央室，而不是外周室。

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.