Influence of hemorrhagic shock on the pharmacokinetics and pharmacodynamics of intravenous anesthetics

失血性休克对静脉麻醉药药代动力学和药效学的影响

• 批准号: 23592250
• 负责人: KURITA Tadayoshi
• 金额: $ 3.33万
• 依托单位: Hamamatsu University School of Medicine
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2011
• 资助国家: 日本
• 起止时间: 2011 至 2013
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-23592250/
• 关键词: 静脈麻酔薬; 薬物動態学; 薬力学; 出血性ショック; レミフェンタニル; プロポフォール; 心拍出量

The remifentanil concentration during continuous infusion undergoes an increase that is three times higher than that for co-administered propofol with progression of haemorrhage. This result indicates that the remifentanil dose should be reduced substantially compared with propofol for patients with significant blood loss.The remifentanil concentration during continuous infusion is affected by cardiac output, which changes easily in response to anaesthetic depth and/or administration of inotropic agents. The extent of the influence of cardiac output on the remifentanil concentration is similar to that on coadministered propofol, in contrast to the responses of these two drugs during haemorrhagic shock. The influence of decreased cardiac output on both drug concentrations is greater than that of increased cardiac output. These results indicate that the actual blood concentrations might substantially deviate from the expected concentrations in a low cardiac output state.

随着出血的进展，连续输注瑞芬太尼的浓度比联合输注异丙酚的浓度增加三倍。这一结果提示，对于大量失血的患者，与异丙酚相比，瑞芬太尼的剂量应大幅减少。持续输注期间的瑞芬太尼浓度受心输出量的影响，心输出量容易随麻醉深度和/或肌力药物的施用而改变。心输出量对瑞芬太尼浓度的影响程度与异丙酚的影响程度相似，与这两种药物在失血性休克期间的反应形成对比。心输出量减少对两种药物浓度的影响大于心输出量增加的影响。这些结果表明，在低心输出量状态下，实际血药浓度可能大大偏离预期浓度。

项目成果

Does the bispectral index (BIS) during haemorrhagic shock and resuscitation reflect a change in cerebral perfusion or simply reflect the anaesthetic depth?

失血性休克和复苏期间的脑电双频指数（BIS）是否反映了脑灌注的变化，还是仅仅反映了麻醉深度？

• 发表时间: 2012
• 期刊: Resuscitation
• 影响因子: 6.5
• 作者: Kurita T;Sato S
• 通讯作者: Sato S

Influence of cardiac output on the pseudo-steady state remifentanil and propofol concentrations in swine

• DOI: 10.1111/aas.12076
• 发表时间: 2013-07-01
• 期刊: ACTA ANAESTHESIOLOGICA SCANDINAVICA
• 影响因子: 2.1
• 作者: Kurita, T.;Uraoka, M.;Sato, S.
• 通讯作者: Sato, S.

Influence of haemorrhage on the pseudo-steady-state remifentanil concentration in a swine model: a comparison with propofol and the effect of haemorrhagic shock stage

• DOI: 10.1093/bja/aer233
• 发表时间: 2011-11-01
• 期刊: BRITISH JOURNAL OF ANAESTHESIA
• 影响因子: 9.8
• 作者: Kurita, T.;Uraoka, M.;Sato, S.
• 通讯作者: Sato, S.

Influence of progressive hemorrhage and subsequent cardiopulmonary resuscitation on the bispectral index during isoflurane anesthesia in a swine model

• DOI: 10.1097/ta.0b013e3182569e9c
• 发表时间: 2012-06-01
• 期刊: JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
• 影响因子: 3.4
• 作者: Kurita, Tadayoshi;Uraoka, Masahiro;Sato, Shigehito
• 通讯作者: Sato, Shigehito