KINETICS OF THIOPENTAL DURING CARDIOPULMONARY BYPASS AND CORONARY REPERFUSION

心肺转流术和冠状动脉再灌注期间硫喷妥钠的动力学

• 批准号: 3963149
• 负责人: P K NARANG
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3963149
• 关键词: anesthetics; blood chemistry; dosage; drug metabolism; heart /lung bypass; heart revascularization; high performance liquid chromatography; human subject; hypothermia; pharmacokinetics; thiopental

Sodium thiopental, a short acting barbiturate, is commonly employed in cardiac surgery as an anesthetic. In order to optimize dosage of this myocardial depressant in patients undergoing cardiopulmonary bypass, we have studied 20 patients and evaluated the influence of hemodilution and hypothermia during the bypass procedure. We quantitated plasma levels of thiopental in patients and kinetically calculated the fraction of drug that is being metabolized hepatically. Although the hepatic extraction and hepatocellular intrinsic clearance are significantly lowered during hypothermic state (temp: 25 degrees C) the thiopental levels at the time of taking the aortic clamp off and when the patient is fully rewarmed were not higher than previously observed in non-bypass patients. This is because the decreased metabolism appears to be counterbalanced by increased free fraction due to hemodilution and may be increased partitioning into tissues e.g., fat. This indicates that no dosage changes may be necessary for anesthetic dose.

硫喷妥钠是一种短效巴比妥酸盐，通常用于治疗 用作心脏手术的麻醉剂 为了优化剂量， 在接受体外循环的患者中，我们 研究了20例患者，并评估了血液稀释的影响， 心脏搭桥手术时体温过低 我们定量了血浆中 硫喷妥钠在病人和动力学计算药物的分数， 在肝脏中代谢 虽然肝脏提取和 肝细胞固有清除率在 低温状态（温度：25摄氏度）的硫喷妥钠水平的时间 当患者完全复温时， 不高于先前在非旁路患者中观察到的水平。 这是 因为减少的新陈代谢似乎被增加的 由于血液稀释，游离分数可能增加， 组织例如，胖了 这表明可能不需要改变剂量 麻醉剂量。