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Sufentanil disposition during cardiopulmonary bypass.

P Flezzani¹, M J Alvis, J R Jacobs

¹Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie

|November 1, 1987

Summary

Computer-assisted continuous infusion (CACI) systems can maintain stable sufentanil plasma levels during cardiopulmonary bypass (CPB). However, this pharmacokinetic approach may lead to drug accumulation during CPB.

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Area of Science:

Anesthesiology
Pharmacokinetics
Cardiovascular Surgery

Background:

Maintaining stable anesthetic drug concentrations is critical during cardiopulmonary bypass (CPB).
Computer-assisted continuous infusion (CACI) offers potential for precise drug delivery.
Sufentanil is a potent opioid commonly used in cardiac anesthesia.

Purpose of the Study:

To evaluate the efficacy of a CACI system in maintaining target sufentanil plasma concentrations during CPB.
To assess the pharmacokinetic behavior of sufentanil using a CACI system in surgical patients.

Main Methods:

Ten patients undergoing CPB received sufentanil via CACI, targeting a central compartment concentration of 5 ng/mL.
Pharmacokinetic data, including plasma sufentanil levels, were collected before, during, and up to 90 minutes after CPB initiation.

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Physiological parameters like hematocrit, protein levels, and temperatures were also monitored.

Main Results:

Sufentanil plasma concentrations reached 3.8 ± 0.4 ng/mL before CPB.
During CPB, concentrations approached the target of 5 ng/mL, reaching 4.7 ± 0.4 ng/mL.
The CACI system demonstrated the ability to achieve and maintain relatively stable sufentanil levels.

Conclusions:

Pharmacokinetically guided CACI can achieve stable sufentanil plasma levels during CPB.
The data suggest a potential for sufentanil accumulation during CPB when using this infusion strategy.
Further research is warranted to optimize CACI protocols and mitigate potential drug accumulation.