Abstract
The pharmacokinetics of alfentanil, 300 μg · kg−1 IV, were determined in patients undergoing elective abdominal aortic reconstruction. The mean age (± SD) of the patients wax 64.3 ±7.4 yr: their mean weight was 74.7 ± 13.8 kg. Five patients underwent aneurysm repair and six had aortobifemoral grafting. Serum alfentanil concentrations were measured by gas-liquid chromatography in samples drawn at increasing intervals over a 24-hr period. A three-compartment model was fitted to the concentration versus time data. The volume of the central compartment and the volume of distribution at steady state (Vdss) were 0.044 ± 0.022 and 0.63 ± 0.32 L · kg−1, respectively. Total drug clearance was 6.4 = 1.9 ml · min−1 · kg−1. The elimination half-time was 3.7 ± 2.6 hr. Patient age was positively correlated with both Vdss and elimination half-time. There were no significant correlations between the pharmacokinetic variables and the duration of aortic cross-clamping, the duration of surgery, or the rate or total volume of IV fluids infused intraoperatively. In general surgical patients, the elimination half-time of alfentanil has been reported to be 1.2–2.0 hr. Although the elimination half-time of alfentanil was longer in patients undergoing abdominal aortic surgery, alfen-tanil was eliminated much faster than either fentanyl or sufentanil in this patient population.
Résumé
Nous avons tracé le profil pharmacocinétique d’une dose intraveineuse de 300 μg · kg−1 d’alfentanil lors de reconstructions électives de l’aorte. Cinq patients subirent une résection d’anévrysme et six autres, un pontage aortobifémoral. Ils avaient en moyenne 64,3 ± 7,4 ans et pesaient 74,7 ± 13,8 kg. On mesura les concentrations sériques d’alfentanil par chromatographie gaz-liquide sur des échantillons prélevés à intervalles croissants pendant 24 h. L’évolution temporelle des concentrations était celle d’un modèle pharmacocinétique tri-compartimental. Le compartiment central avait un volume de 0,044 ± 0,022 L · kg−1 et le volume de distribution à l’équilibre (Vdss était de 0,63 ± 0,32 L · kg−1: la clairance était de 6.4 ±1,9 ml · min−1 · kg−1 et la demievie d’élimination, 3,7 ± 2,6 h. Il y avait une corrélation positive entre l’âge du patient, le Vdss et la demievie. Les variables pharmacocinétiques étaient toutefois indépendantes de la durée du clampage aortique et de l’intervention, de même que du débit et du volume des liquides perfusés par voie veineuse pendant l’opération. Même si elle s’est avérée plus longue que celle de 1,2 à 2 h observée en chirurgie générale, la demievie d’élimination de l’alfentanil est beaucoup plus courte que celles du fentanyl et du sufentanil lors de chirurgie aortique.
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Supported by the Manitoba Heart and Stroke Foundation and Janssen Pharmaceutica (Canada) Inc.
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Hudson, R.J., Thomson, I.R., Burgess, P.M. et al. Alfentanil pharmacokinetics in patients undergoing abdominal aortic surgery. Can J Anaesth 38, 61–67 (1991). https://doi.org/10.1007/BF03009165
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DOI: https://doi.org/10.1007/BF03009165