TOXICITY OF BUPIVACAINE, WITH REFERENCE TO ITS METABOLITES

对4例ICU肝功能衰竭患者静脉注射吲哚青绿(ICG)的药代动力学进行了研究。观察血清胆红素、贫血升高，意识状态为肝昏迷II~III级。静脉注射ICG 0.5 mg/kg，用高效液相色谱法测定其血药浓度。清除量减少，分布半衰期升高，消除半衰期符合二室模型。房室分析显示，平均停留时间延长，分布量增加，清除量减少。二房室模型更适合于ICG的药代动力学分析，分布体积比血浆体积扩大更多，提示ICG分布于血管外空间。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部分，而不是外周部分。

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.