Skip to main content
SpringerLink
Log in

Pharmacokinetics in Intravenous Anaesthetic Practice

  • Published:
Clinical Pharmacokinetics Aims and scope Submit manuscript

Summary

Intravenous agents used in anaesthetic practice comprise three different groups of compounds: intravenous general anaesthetics, narcotic analgesics and skeletal muscle relaxants. All these drugs are characterised by a rapid onset of action and a short duration of action. These properties are the result of a number of common physicochemical and pharmacokinetic characteristics. The high lipid solubility of general anaesthetics and of narcotic analgesics explains their rapid onset of action when they are administered intravenously. The short duration of action corresponds to a rapid decline of the plasma concentration due to tissue distribution for most agents. The influence of elimination processes must also be considered, especially for long lasting operative procedures at the end of which a high cumulative dose of narcotic analgesics and muscle relaxants has been administered.

Knowledge of the pharmacokinetics of the agents used may be of some help in the understanding of two serious anaesthetic accidents: (I) hypotension and cardiac.arrest during induction of anaesthesia which is due to an overdose of intravenous general anaesthetic; and (2) respiratory depression and respiratory arrest which can be attributed to a prolonged effect of narcotic analgesics and muscle relaxants. Thus, special attention must be focussed on the factors influencing the initial blood concentration for general anaesthetics and those influencing elimination processes for narcotic analgesics and muscle relaxants.

For thiopentone, an excessive initial blood concentration results in hypotension. It may be related to an excessively rapid rate of injection, a reduced volume in which the drug initially distributes and/or a reduced protein-bound fraction. Distribution processes will mostly influence the duration of action of anaesthetics. Hepatic biotransformation of general anaesthetics will hardly influence their duration of action because of the relatively long elimination half-life of about 2 to 6 hours except for althesin, this drug being more rapidly metabolised with an elimination half-life of 0.5 hours.

In contrast, elimination processes may influence the duration of action of narcotic analgesics and muscle relaxants. Knowledge about the pharmacokinetics of narcotic analgesics is incomplete and contradictory, especially for morphine. The elimination half-lives of morphine, pethidine (meperidine), pentazocine and fentanyl are similar (2.5 to 3.5 hours). Narcotics are eliminated by hepatic biotransformation. In liver parenchymal disease, prolongation of the elimination half-life has only been demonstrated for pethidine.

In contrast to general anaesthetics and narcotic analgesics, muscle relaxants are highly hydrophilic compounds. Their volume of distribution is limited approximately to that of the extracellular fluids. Non-depolarising muscle relaxants are mainly excreted unchanged through the kidneys according to an ultrafiltration process. Biliary excretion represents an accessory pathway of excretion for all these compounds, except gallamine. Hepatic biotransformation is negligible. Their elimination half-lives are of about 2 to 3 hours. Higher values have, however, been reported for d-tubocurarine. Renal failure is the main cause of prolongation of action of non-depolarising relaxants. A less important cause of prolongation of the elimination half-life, for at least some relaxants, is the presence of hepatic parenchymal disease or cholestasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Agoston, S.; Vermeer, G.A.; Kersten, U.W. and Meijer, D.K.F.: The fate of pancuronium bromide in man. Acta Anaesthesiologica Scandinavica 17: 267–275 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Agoston, S.; Crul, J.F.; Kersten, U.W. and Scaf, A.H.J.: Relationship of the serum concentration of pancuronium to its neuromuscular activity in man. Anesthesiology 47: 509–512 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Agoston, S.; Vermeer, G.A.; Kersten, U.W. and Scaf, A.H.J.: A preliminary investigation of the renal and hepatic excretion of gallamine trioethiodide in man. British Journal of Anaesthesia 50: 345–351 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Agoston, S.; Feldman, S.A. and Miller, R.D.: Plasma concentrations of pancuronium and neuromuscular blockade afer injection into the isolated arm, bolus injection and continuous infusion. Anesthesiology 51: 119–122 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Agurell, S.; Boreus, L.O.; Gordon, E.; Lindgren, J.E.; Ehrnebo, M. and Lönroth, U.: Plasma and cerebrospinal fluid concentration of pentazocine in patients: assay by mass fragmentography. Journal of Pharmacy and Pharmacology 26: 1–8 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Ali, H.H. and Savarese, J.J.: Monitoring neuromuscular function. Anesthesiology 45: 216–249 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Alvin, J.; McHorse, T.; Hoyumpa, A.; Bush, M.T. and Schenker, S.: The effect of liver disease in man on the disposition of phénobarbital. Journal of Pharmacology and Experimental Therapeutics 192: 224–235 (1975).

    PubMed  CAS  Google Scholar 

  • Aquilonious, S.M.; Eckernäs, S.A.; Hartvig, P.; Hultman, J.; Lindström, B. and Osterman, P.O.: A pharmacokinetic study of neostigmine in man using gas chromatography — mass spectrometry. European Journal of Clinical Pharmacology 15: 367–371 (1979).

    Article  Google Scholar 

  • Baraka, A. and Gabali, F.: Correlation between tubocurarine requirements and plasma protein patterns. British Journal of Anaesthesia 40: 89–93 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Becker, K.E.: Gas chromatography assay for free and total plasma levels of thiopental. Anesthesiology 45: 656–660 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Becker, K.E.: Plasma levels of thiopentai necessary for anesthesia. Anesthesiology 49: 192–196 (1978).

    Article  PubMed  Google Scholar 

  • Benson, D.W.; Kaufman, J.J. and Koski, W.S.: Theoretic significance of pH dependence of narcotics and narcotic antagonists in clinical anesthesia. Anesthesia and Analgesia Current Researches 55: 253–257 (1976).

    CAS  Google Scholar 

  • Berkowitz, B.A.; Ngai, S.H.; Yang, J.C.; Hempstead, J. and Spector, S.: The disposition of morphine in surgical patients. Clinical Pharmacology and Therapeutics 17: 629–635 (1975a).

    PubMed  CAS  Google Scholar 

  • Berkowitz, B.A.; Ngai, S.H.; Yang, J.C., Hempstead, J. and Spector, S.:Disposition of naloxone: use of a new radioimmunoassay. Journal of Pharmacology and Therapeutics 17: 629–635 (1975b).

    CAS  Google Scholar 

  • Berkowitz, B.A.: The relationship of pharmacokinetics to pharmacological activity: morphine, methadone and naloxone. Clinical Pharmacokinetics 1: 219–230 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Bolger, L.; Brittain, R.T; Jack, D.; Jackson, M.R.; Poynte, D. and Tyer, M.B.: Short-lasting, competitive neuromuscular blocking activity in a series of azobisarylimidazo-(1,2-a)-pyridinium dihalides. Nature (London) 238: 354–355 (1972).

    Article  CAS  Google Scholar 

  • Breimer, D.D.: Pharmacokinetics of methohexitone following intravenous infusion in humans. British Journal of Anaesthesia 48: 643–649 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Breimer, D.D.: Clinical pharmacokinetics of hypnotics. Clinical Pharmacokinetics 2: 93–109 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Brunk, S.F. and Delle, M.: Morphine metabolism in man. Clinical Pharmacology and Therapeutics 16: 51–57 (1974).

    PubMed  CAS  Google Scholar 

  • Buchanan, N. and Van der Walt, L.A.: The binding of thiopentone to kwashiorkor serum. British Journal of Anaesthesia 49: 247–250 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Caldwell, J.; Wakile, L.A.; Notarianni, L.J.; Smith, R.L.; Correy, G.J.; Lieberman, B.A.; Beard, R.W.; Finnie, M.D.A. and Snedden, W.: Maternal and neonatal disposition of pethidine in childbirth — a study using quantitative gas chromatography-mass spectrometry. Life Sciences 22: 589–596 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Calvey, T.N.; Wareing, M.; Williams, N.E. and Chan, K.: Pharmacokinetics and pharmacological effects of neostigmine in man. British Journal of Clinical Pharmacology 7: 149–155 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Camu, F. and D’Hollander, A.: Neuromuscular blockade of fazadinium bromide (AH 8165) in renal failure patients. Acta Anaesthesiologica Scandinavica 22: 221–226 (1978).

    PubMed  CAS  Google Scholar 

  • Carlos, R.; Calvo, R. and Erill, S.: Plasma protein binding of etomidate in patients with renal failure or hepatic cirrhosis. Clinical Pharmacokinetics 4: 144–148 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Carroll, F.I.; Smith, D.; Mark, L.C.; Brand, L. and Perel, J.M.: Determination of optically active thiopental, thiamylal, and their metabolites in human urine. Drug Metabolism and Disposition 5: 343–354 (1977).

    PubMed  CAS  Google Scholar 

  • Chan, K.; Kendall, M.J.; Mitchard, M; and Wells, W.D.E.: The effect of ageing on plasma pethidine concentration. British Journal of Clinical Pharmacology 2: 297–302 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Chan, K.; Williams, N.E. and Calvey, T.N.: Elimination of pyridostigmine in man. Abstracts of the Scientific Papers, 7th International Congress of Pharmacology, p.276 (Pergamon, Oxford 1978).

    Google Scholar 

  • Child, K.J.; Gibson, W.; Harnby, G. and Hart, J.W.: Metabolism and excretion of Althesin (CT 1341) in the rat. Postgraduate Medical Journal 48 (Suppl. 2): 37–42 (1972).

    PubMed  CAS  Google Scholar 

  • Cohan, S.L.; Pohlmann, J.L.W.; Mikszewski, J. and O’Doherty, D.S.: The pharmacokinetics of pyridostigmine. Neurology 26: 536–539 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Cohen, E.N.; Corbascio, A. and Fleischli, G.: The distribution and fate of d-tubocurarine. Journal of Pharmacology and Experimental Therapeutics 147: 120–129 (1965).

    PubMed  CAS  Google Scholar 

  • Cohen, M.L.; Chan, S.L.; Way, W.L. and Trevor, A.J.: Distribution in the brain and metabolism of ketamine in the rat after intravenous administration. Anesthesiology 39: 370–376 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Corail, I.M.; Moore, A.R. and Strunin, L.: Plasma concentration of fentanyl in normal surgical patients and those with severe renal and hepatic disease. British Journal of Anaesthesia 52: 101 (1980).

    Article  Google Scholar 

  • Doenicke, A.; Krumey, I.; Kugler, J. and Klempa, J.: Experimental studies of the breakdown of Epontol: Determination of propanidid in human serum. British Journal of Anaesthesia 40: 415–429 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Doenicke, A.; Kugler, J.; Kalmar, L.; Bezecny, H.; Laub, M.; Schmidinger, K. and Slavik, B.: Klinisch experimentelle Untersuchungen mit propanidid. Anaesthesit 22: 255–262 (1973).

    CAS  Google Scholar 

  • Jon, H.F.; Diepa, R.A. and Taylor, P.: Narcotic analgesics in anuric patients. Anesthesiology 42: 745–747 (1975).

    Article  Google Scholar 

  • Drabkova, J.; Crul, J.F. and Van der Kleijn, E.: Placental transfer of 14C-labelled succinylcholine in near-term macaca mulatta monkeys. British Journal of Anaesthesia 45: 1087–1096 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Duvaldestin, P. and Vourc’h, G.: Problémes posés par l’anesthésie dans les transplantations rénales. Anesthésie, Analgésie, Réanimation 31: 333–359 (1974).

    PubMed  CAS  Google Scholar 

  • Duvaldestin, P.; Henzel, D.; Gilles, M.R.; Roze, C. and Desmonts, J.M.: Etude de la pharmacocinétique de la gallamine chez l’homme. Anesthésie, Analgésie, Réanimation 34: 235–239 (1977).

    PubMed  CAS  Google Scholar 

  • Duvaldestin, P.; Henzel, D.; Demetriou, M. and Desmonts, J.M.: Pharmacokinetics of fazadinium in man. British Journal of Anaesthesia 50: 773–777 (1978a).

    Article  PubMed  CAS  Google Scholar 

  • Duvaldestin, P.; Agoston, S.; Henzel, D.; Kersten, U.W. and Desmonts, J.M.: Pancuronium pharmacokinetics in patients with liver cirrhosis. British Journal of Anaesthesia 50: 1131–1136 (1978b).

    Article  PubMed  CAS  Google Scholar 

  • Duvaldestin, P.; Bertrand, J.C.; Concina, D.; Henzel, D.; Lareng, L. and Desmonts, J.M.: Fazadinium pharmacokinetics in patients with renal failure. British Journal of Anaesthesia 51: 943–947 (1979a).

    Article  PubMed  CAS  Google Scholar 

  • Duvaldestin, P.; Gibert, C.; Henzel, D.; Guy, P. and Desmonts, J.M.: Pancuronium blood level monitoring in patients with tetanus. Intensive Care Medicine 5: 105–110 (1979b).

    Article  Google Scholar 

  • Eger, E.I., II; Saidman, L.J. and Brandstater, B.: Minimum alveolar anesthetic concentration: a standard anesthetic potency. Anesthesiology 26: 756–763 (1965).

    Article  PubMed  Google Scholar 

  • Ehrnebo, M.; Boreus, L.O. and Lonroth, U.: Bioavailability and first-pass metabolism of oral pentazocine in man. Clinical Pharmacology and Therapeutics 22: 888–892 (1977).

    PubMed  CAS  Google Scholar 

  • Feldman, S.A.; Cohen, E.N. and Golling, R.C.: The excretion of gallamine in the dog. Anesthesiology 30: 593–598 (1969).

    Article  PubMed  CAS  Google Scholar 

  • Foldes, F.F.: Distribution and biotransformation of succinylcholine. International Anesthesiology Clinics 13: 101–115 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Fishman, J.; Roffwang, H. and Hellman, L.: Disposition of naloxone-7, 8-3H in normal and narcotic dependent man. Journal of Pharmacology and Experimental Therapeutics 187: 575–580 (1973).

    PubMed  CAS  Google Scholar 

  • Fung, D.L.; Eisele, J.H.; Asling, J.H. and Martucci, R.W.: The respiratory response to CO2 following intravenous meperidine in man. American Society of Anesthesiologists Annual Meeting, pp.257–258 (1975).

  • Ghoneim, M.M. and Pandya, H.: Plasma protein binding of thiopental in patients with impaired renal or hepatic function. Anesthesiology 42: 545–549 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Ghoneim, M.M., and Korttila, K.: Pharmacokinetics of intravenous anaesthetics: Implications for clinical use. Clinical Pharmacokinetics 2: 344–372 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Ghoneim, M.M., and Van Hamme, M.J.: Pharmacokinetics of thiopentone: Effect of enflurane and nitrous oxide anaesthesia and surgery. British Journal of Anaesthesia 50: 1237–1241 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Ghoneim, M.M. and Van Hamme, M.J.: Hydrolysis of etomidate. Anesthesiology 50: 227–229 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Goat, V.A.; Yeung, M.L.; Blakeney, C. and Feldman, S.A.: The effect of blood flow upon the activity of gallamine triethiodide. British Journal of Anaesthesia 48: 69–73 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Goudsouzian, N.G.; Ryan, J.F and Savarese, J.J.: The neuromuscular effects of pancuronium in infants and children. Anesthesiology 41: 95–98 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Ham, J.; Miller, R.D.; Berret, L.Z.; Matteo, R.S. and Roderick, L.L.: Pharmacokinetics and pharmacodynamics of d-tubocurarine during hypothermia in the cat Anesthesiology 49: 324–329 (1978).

    CAS  Google Scholar 

  • Hargrave, S.A.: Estimation of binding of 3H-fentanyl to plasma proteins. British Journal of Anaesthesia 51: 569p–570p (1979).

    Google Scholar 

  • Hess, R.; Hertz, A. and Friedel, K.: Pharmacokinetics of fentanyl in rabbits in view of the importance for limiting the effect. Journal of Pharmacology and Experimental Therapeutics 179: 474–484 (1971).

    PubMed  CAS  Google Scholar 

  • Hogg, M.I.J.; Wiener, P.C.; Rosen, M. and Mapleson, W.W.: Urinary excretion and metabolism of pethidine and norpethidine in the newborn. British Journal of Anaesthesia 49: 891–899 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Horowitz, P.E. and Spector, S.: Determination of serum d-tubocurarine concentration by radioimmunoassay. Journal of Pharmacology and Experimental Therapeutics 185: 94–100 (1973).

    PubMed  CAS  Google Scholar 

  • Hug, C.C. and Murphy, M.R.: Fentanyl disposition in cerebrospinal fluid and plasma and its relationship to ventilatory depression in the dog. Anesthesiology 50: 342–349 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Hull, C.J.: A pharmacokinetic model for pancuronium. British Journal of Anaesthesia 50: 1113–1123 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Kersten, U.W.; Meijer, D.K.F. and Agoston, S.: Fluorimetric and Chromatographic determination of pancuronium bromide and its metabolites in biological materials. Clinica Chimica Acta 44: 59–66 (1973).

    Article  CAS  Google Scholar 

  • Klotz, U.; McHorse, T.S.; Wilkinson, G.R. and Schenker, S.: The effect of cirrhosis on the disposition and elimination of meperidine in man. Clinical Pharmacology and Therapeutics 16: 667–675 (1974).

    PubMed  CAS  Google Scholar 

  • Klotz, U.; Avant, G.R.; Hoyumpa, A.; Schenker, S. and Wilkinson, G.K.: The effect of age and liver disease on the disposition and elimination of diazepam in adult man. Journal of Clinical Investigation 55: 347–359 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Kurz, H.: Eiweissbinding von intravenosen Narkosemitteln: in Zindler, Yamamura and Wirth (Eds) Intravenose Narkose mit Propanidid, pp. 16–24 (Springer Verlag, Berlin 1973).

    Chapter  Google Scholar 

  • Litwiller, R.W.: Succinylcholine hydrolysis. Anesthesiology 31: 356–360 (1969).

    Article  PubMed  CAS  Google Scholar 

  • Marietta, M.P.; White, P.F.; Pudwill, C.R.; Way, W.L. and Trevor, A.J.: Biodisposition of ketamine in the rat: Self-induction of metabolism. Journal of Pharmacology and Experimental Therapeutics 196: 536–544 (1976).

    CAS  Google Scholar 

  • Mather, L.E. and Meffin, P.J.: Clinical pharmacokinetics of pethidine. Clinical Pharmacokinetics 3: 353–368 (1978).

    Article  Google Scholar 

  • Mather, L.E.; Tucker, G.T.; Pflug, A.E.; Lindop, M.J. and Wilkerson, C.: Meperidine kinetics in man. Clinical Pharmacology and Therapeutics 17: 21–30 (1975).

    PubMed  CAS  Google Scholar 

  • Matteo, R.S.; Spector, S. and Horowitz, P.E.: Relation of serum d-tubocurarine concentration to neuromuscular blockade in man. Anesthesiology 41: 440–443 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Matteo, R.S.; Pirar, E.K.; Khambatta, H.J. and Spector, S.: Cerebrospinal fluid levels of d-tubocurarine in man. Anesthesiology 46: 396–399 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Matteo, R.S.; Nishitateno, K.; de Guzman, R. and Khambatta, H.J.: Pharmacokinetics of metocurine in man. American Society of Anesthesiologists 251-252 (1978).

  • McHorse, T.S.; Wilkinson, G.R.; Johnson, R.F. and Skenker, S.: Effect of acute viral hepatitis in man on the disposition and elimination of meperidine. Gastroenterology 68: 775–780 (1975).

    PubMed  CAS  Google Scholar 

  • McLeod, K.; Watson, M.J. and Rawlins, M.D.: Pharmacokinetics of pancuronium in patients with normal and impaired renal function. British Journal of Anaesthesia 48: 341–345 (1976).

    Article  PubMed  CAS  Google Scholar 

  • McLeod, K.; Hull, C.J. and Watson, M.J.: The effects of ageing on the pharmacokinetics of pancuronium. British Journal of Anaesthesia 51: 435–438 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Meijer, D.K.F.; Weitering, J.G.; Vermeer, G.A. and Scal, A.H.J.: Comparative pharmacokinetics of d-tubocurarine and metocurine in man. Anesthesiology 51: 402–407 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Michels, M.; Hendriks, R. and Heykants, J.: A sensitive radioimmunoassay for fentanyl. European Journal of Clinical Pharmacology 12: 153–158 (1977).

    Article  Google Scholar 

  • Miller, R.D.; Eger, E.I., II; Way, W.L.; Stevens, W.C. and Dolan, W.M.: Comparative neuromuscular effects of forane and halothane alone and in combination with d-tubocurarine in man. Anesthesiology 35: 38–42 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Miller, R.D., Matteo, R.S.; Benet, L.Z. and Sohn, Y.J.: The pharmacokinetics of d-tubocurarine in man with and without renal failure. Journal of Pharmacology and Therapeutics 202: 1–7 (1977).

    CAS  Google Scholar 

  • Miller, R.D.; Agoston, S.; Booij, L.H.D.J.; Kersten, U.W.; Crul, J.F. and Ham, J.: The comparative potency and pharmacokinetics of pancuronium and its metabolites in anesthetized man. Journal of Pharmacology and Experimental Therapeutics 207: 539–543 (1978a).

    PubMed  CAS  Google Scholar 

  • Miller, R.D.; Agoston, S.; Van der Pol, D.; Booij, L.H.D.J.; Crul, J.F. and Ham, J.: Hypothermia and the pharmacokinetics and pharmacodynamics of pancuronium in the cat. Journal of Pharmacology and Experimental Therapeutics 207: 532–538 (1978b).

    PubMed  CAS  Google Scholar 

  • Miller, R.D.; Agoston, S.; Van der Pol, F.; Booij, L.H.D.J. and Crul, J.F.: Effect of different anaesthetics on the pharmacodynamics of pancuronium in the cat. Acta Anaesthesiologica Scandinavica 23: 285–290 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Mostert, J.W.; Evers, J.L.; Hokiba, R.H. and Ambrus, J.L.: Cardiorespiratory effect of anaesthesia with morphine or fentanyl in chronic renal failure and cerebral toxicity after morphine. British Journal of Anaesthesia 43: 1053–1069 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Ngai, S.H.; Berkowitz, B.A.; Yang, J.C.; Hempstead, J. and Spector, S.: Pharmacokinetics of naloxone in rats and in man. Anesthesiology 44: 398–401 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Nishitateno, K.; Ngai, S.H.; Finck, A.D. and Berkowitz, B.A.: Pharmacokinetics of morphine: Concentrations in the serum and brain of the dog during hyperventilation. Anesthesiology 50: 520–523, 1979.

    Article  PubMed  CAS  Google Scholar 

  • Novelli, G.P.; Marsili, M. and Lorenzi, P.: Influence of liver metabolism on the actions of althesin and thiopentone. British Journal of Anaesthesia 47: 913–916 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Olivero, J.P.; Duvaldestin, P.; Henzel, D.; Guy, P. and Glaser, P.: Pharmacokinetics of pancuronium during continuous infusion in patients with acute renal failure. Abstracts of Scientific papers, Fifth European Congress of Anaesthesiology, p. 101 (Excerpta Medica, Amsterdam, Oxford 1978).

    Google Scholar 

  • Olsen, G.D.: Morphine binding to human plasma proteins. Clinical Pharmacology and Therapeutics 17: 31–35 (1975).

    PubMed  CAS  Google Scholar 

  • Olsen, G.D.; Chan, E.M. and Riker, W.K.: Binding of d-tubocurarine di(methyl-14C) ether iodide and other amines to cartilage, chondroitin sulfate and human plasma proteins. Journal of Pharmacology and Experimental Therapeutics 195: 242–250 (1975).

    PubMed  CAS  Google Scholar 

  • Pastorino, A.M.: Fluorimetric determination and pharmacokinetic studies of fazadinium bromide in dogs. Arzneimittel-Forschung 28: 1728–1730 (1978).

    PubMed  CAS  Google Scholar 

  • Pittman, K.A.: Human metabolism of orally administered pentazocine. Biochemical Pharmacology 19: 1826–1833 (1970).

    Article  Google Scholar 

  • Pütter, J. and Stockhausen, H.: Nerve pharmakokinetische Untersuchungsergebnisse uber Propanidid, in Zindler, Yamamura and Wirth (Eds) Intravenose Narkose mit Propranidid, pp.3–15 (Springer-Verlag, Berlin 1973).

    Chapter  Google Scholar 

  • Raaflaub, J. and Frey, P.: Zur Pharmakokinetik von diallylnortoxiferin beim Menschen. Arzneimittel-Forschung 22: 73–78 (1972).

    PubMed  CAS  Google Scholar 

  • Rigg, J.R.A.: Ventilatory effects and plasma concentration of morphine in man. British Journal of Anaesthesia 50: 759–765 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Rowe, J.W.: Clinical research on aging: Strategies and direction. New England Journal of Medicine 297: 1332–1336 (1977).

    Article  PubMed  Google Scholar 

  • Ryan, D.W.: Preoperative serum Cholinesterase concentration in chronic renal failure. British Journal of Anaesthesia 49: 945–949 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Saidman, L.J.: Uptake, distribution and elimination of barbiturates, in Eger (Ed) Anesthetic Uptake and Action, pp.264–284 (Williams and Wilkins Company, Baltimore 1974).

    Google Scholar 

  • Saidman, L.J. and Eger, E.I.: The effect of thiopental metabolism on duration of anesthesia. Anesthesiology 27: 118–126 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Schleimer, R.; Benjamini, E.; Eisele, J. and Henderson, G.: Pharmacokinetics of fentanyl as determined by radioimmunoassay. Clinical Pharmacology and Therapeutics 23: 188–194 (1978).

    PubMed  CAS  Google Scholar 

  • Sellers, E.M. and Koch-Weser, J.: Influence of intravenous injection rate on protein-binding and vascular activity of diazoxide. Annals of the New York Academy of Sciences 226: 319–332 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Shanks, C.A.; Sompgyi, A.A. and Triggs, E.J.: Dose-response and plasma-concentration-response relationships in man. Anesthesiology 51: 111–118 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Sheiner, L.B.; Stanski, D.R.; Vozeh, S.; Miller, R.D. and Ham, J.; Simultaneous modeling of pharmacokinetics and pharmacodynamics: Application of d-tubocurarine. Clinical Pharmacology and Therapeutics 25: 358–371 (1979).

    PubMed  CAS  Google Scholar 

  • Simpson, M.E.: Pharmacokinetics of althesin — comparison with lignocaine. British Journal of Anaesthesia 50: 1231–1235 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Somogyi, A.A.; Shanks, C.A. and Triggs, E.J.: Clinical pharmacokinetics of pancuronium bromide. European Journal of Clinical Pharmacology 10: 367–372 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Soudijn, W.; Van Wijngaarden, I. and Janssen, P.A.J.: Biotransformation of neuroleptanalgesics. International Anesthesiology Clinics 12: 145–155 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Stanley, T.H. and Lathrop, G.D.: Urinary excretion of morphine during and after valvular and coronary artery surgery. Anesthesiology 46: 166–169 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Stanski, D.R.; Greenblatt, D.J. and Lowenstein, E.: Kinetics of intravenous and intramuscular morphine. Clinical Pharmacology and Therapeutics 24: 52–59 (1978a).

    PubMed  CAS  Google Scholar 

  • Stanski, D.R.; Ham, J., Muller, R.D. and Sheiner, L.B.: Pharmacokinetics and pharmacodynamics of d-tubocurarine under N20: Narcotic and halothane anesthesia. American Society of Anesthesiologists: 249-250 (1978b).

  • Szeto, H.H.; Intrurrisi, C.E.; Houde, R.; Saal, S.; Cheigh, J. and Reidenberg, M.M.: Accumulation of normeperidine, an active metabolite of meperidine, in patients with renal failure or cancer. Annals of Internal Medicine 86: 738 (1977).

    PubMed  CAS  Google Scholar 

  • Thompson, J.M.: Pancuronium binding by serum proteins. Anaesthesia 31: 219–227 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Thron, C.D.: Linearity and superposition in pharmacokinetics. Pharmacological Reviews 26: 3–31 (1974).

    PubMed  CAS  Google Scholar 

  • Van der Maeden, F.P.B.; Van Rens, P.T.; Buytenhuys, F.A. and Buurman, E.: Quantitative analysis of d-tubocurarine chloride in curare by column liquid chromatography. Journal of Chromatography 142: 715–723 (1977).

    Article  PubMed  Google Scholar 

  • Van Hamme, M.J.; Choneim, M.M. and Ambere, J.J.: Pharmacokinetics of Etomidate, a new intravenous anesthetic. Anesthesiology 49: 274–277 (1978).

    Article  PubMed  Google Scholar 

  • Vonk, R.J.; Westra, P.; Houwertjes, M.C. and Agoston, S.: Prolongation by bile salts of the duration of action of a steroidal neuromuscular blocking agent. British Journal of Anaesthesia 51: 719–723 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Walts, L.F. and Dillon, J.B.: Clinical studies on succinylcholine chloride. Anesthesiology 28: 372–376 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Waser, P.: Localization of 14C-pancuronium by histo- and wholebody autoradiography in normal and pregnant mice. Naunyn Schmiedeberg’s Archives of Pharmacology 279: 399–412 (1973).

    Article  PubMed  CAS  Google Scholar 

  • White, P.F.; Marietta, M.P.; Pudwill, C.R.; Way, W.L. and Trevor, A.J.: Effects of halothane anesthesia on the biodisposition of ketamine in rats. Journal of Pharmacology and Experimental Therapeutics 19: 545–555 (1976).

    Google Scholar 

  • Wieber, J.; Gugler, R.; Hengstmann, J.H. and Dengler, H.J.: Pharmacokinetics of ketamine in man. Anaesthesist 24: 260–263 (1975).

    PubMed  CAS  Google Scholar 

  • Yeh, S.Y.: Urinary excretion of morphine and its metabolites in morphine dependent subjects. Journal of Pharmacology and Experimental Therapeutics 192: 201–210 (1975).

    PubMed  CAS  Google Scholar 

  • Yeh, S.Y.; Gorodetzky, C.W. and Krebs, H.A.: Isolation and identification of morphine 2- and 6-glucuronides morphine 3,6-diglucuronide, morphine 3-Elhereal Sulfate, normorphine and normorphine 6-glucuronide as morphine metabolites in humans. Journal of Pharmaceutical Sciences 66: 1288–1293 (1977).

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anaesthesia, Hôpitalpital Bichat, Université Paris VII, Paris, France

    P. Duvaldestin

Authors
  1. P. Duvaldestin
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duvaldestin, P. Pharmacokinetics in Intravenous Anaesthetic Practice. Clin Pharmacokinet 6, 61–82 (1981). https://doi.org/10.2165/00003088-198106010-00003

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003088-198106010-00003

Keywords

Search

Navigation