在心肺旁路术期间,雷米芬坦尼尔血蛋白结合率的变化
Hiroshi Ueda1, Tadayoshi Kurita1, Shingo Kawashima1
1Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
British journal of clinical pharmacology
|September 10, 2024
概括
心肺旁路 (CPB) 显著降低了雷米芬坦尼尔与蛋白质的结合,与普罗波不同. 这表明remifentanil在CPB期间可能没有增强的药理作用.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 心血管外科心血管外科
背景情况:
- 心肺绕道 (CPB) 通过减少血蛋白结合,可以改变麻醉剂的药理动力学.
- 增加未结合的药物分数可能会增强药理学效果.
- CPB对雷米芬坦尼尔蛋白结合的影响尚未得到充分证实.
研究的目的:
- 为了研究在CPB期间雷米芬坦尼尔蛋白结合的变化.
- 为了将这些变化与普罗波的变化进行比较.
主要方法:
- 招募了13名接受CPB心血管手术的成年患者.
- 在CPB前,CPB期间和CPB后测量了雷米芬坦尼尔和普罗波的血度.
- 均衡透析用于确定未结合的药物分量.
- 液体染色学-质谱学量化药物度.
主要成果:
- 瑞米芬坦尼尔与蛋白质的结合从CPB前的27.9%降至CPB期间的13.5-14.0%.
- 在CPB期间,普罗波与蛋白质的结合从97.5%降至95.3-95.8%.
- 两种药物都显示CPB期间蛋白质结合减少,CPB后逆转.
- 没有结合的部分增加了remifentanil的1.2倍和propofol的1.7-1.9倍.
结论:
- 在CPB期间,雷米芬坦尼尔与蛋白质的结合显著减少.
- 醇与蛋白质的结合也减少,但比例较小.
- 与普罗波相比,雷米芬坦尼尔在CPB期间可能不会表现出明显增强的药理效应.
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