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腹腔内利多卡因用于成年人持续的术后止痛的药理动力学
Kenyon W Osborne1, Wiremu S MacFater2, Brian J Anderson3
1Department of Pharmacology and Clinical Pharmacology, University of Auckland, Auckland, New Zealand.
概括
在腹部手术后,腹腔内皮质利多卡因的吸收缓慢,大约三分之一的剂量没有进入全身循环. 然而,模拟表明,2mg/kg/h输液可以在36分钟内显著降低疼痛评分.
科学领域:
- 药理动力学和药理动力学
- 麻醉学 麻醉学
- 外科手术止痛药是一种手术止痛药.
背景情况:
- 内利多卡因是腹部手术的有前途的止痛药.
- 它的药理动力学特征,特别是未结合的度,需要详细的建模.
- 对于优化疼痛管理来说,了解腹膜内注射后利多卡因的行为至关重要.
研究的目的:
- 在腹膜内和静脉注射后,为未结合的和总的利多卡因开发药理动力学模型.
- 量化腹腔内利多卡因的吸收特性.
- 探索利多卡因度与疼痛减轻之间的关系.
主要方法:
- 利用了一项随机对照试验 (n=56) 的成年人进行腹腔镜结肠切除的数据.
- 测量了未结合和总利多卡因度和疼痛评分 (VAS 0-10).
- 采用了未结合的利多卡因动态的区间建模和对α-1-酸糖蛋白 (AAG) 结合的营业额模型.
主要成果:
- 内利多卡因的吸收不完全 (生物可用性为0.66),半衰期为0.5小时.
- 一个两部分的模型最好地描述了利多卡因的排泄,其未结合的清除值为121 L/h/70 kg.
- 对AAG (KD) 的结合常数为2.98μmol/L,而药学动力学模型表明C50为0.21 mg/L的减轻疼痛.
结论:
- 大约33%的腹腔内利多卡因剂量没有进入中央区,吸收时间约为2小时.
- 模拟表明,2mg/kg/h的腹腔内输注可以在大约36分钟内实现疼痛评分的5分降低.
- 这些发现支持腹腔内利多卡因在术后有效止痛方面的潜力.
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