Propofol infusion for induction and maintenance of anaesthesia in patients with end-stage renal disease

被引:34
作者
Ickx, B
Cockshott, ID
Barvais, L
Byttebier, G
De Pauw, L
Vandesteene, A
D'Hollander, AA
机构
[1] CUB Erasme, Dept Anaesthesiol, B-1070 Brussels, Belgium
[2] CUB Erasme, Dept Nephrol, B-1070 Brussels, Belgium
[3] Zeneca Pharmaceut, Macclesfield SK10 4TG, Cheshire, England
[4] Zeneca Pharmaceut, Biometr Unit, Dept Med, B-9070 Destelbergen, Belgium
关键词
anaesthetics i.v; propofol; anaesthetic techniques; i.v; infusion; kidney; failure; pharmacokinetics;
D O I
10.1093/bja/81.6.854
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We have investigated the pharmacokinetics and pharmacodynamics of propofol in 11 patients with end-stage renal disease (ESRD) compared with nine healthy patients during and after a manually controlled three-stage infusion of propofol 21, 12 and 6 mg kg(-1) h(-1) lasting a minimum of 2 h. Mean total body clearance was not reduced significantly in the ESRD group (30.66 (SD 8.47) mi kg(-1) min(-1)) compared with the control group (33.75 (7.8) mi kg(-1) min(-1)). ESRD patients exhibited a greater, but not statistically significant, volume of distribution at steady state compared with patients in the control group (11.25 (8.86) vs 5.79 (2.14) litre kg(-1), respectively). Elimination half-life values were unchanged by renal failure. Mean times to induction of anaesthesia were similar in both groups: 177 (SD 57) and 167 (58) s for the ESRD and control groups, respectively. Waking time after cessation of propofol infusion was significantly shorter in the ESRD group (474 (156) s) compared with the control group (714 (240) s) (P<0.05). Mean plasma concentrations on waking were similar. We conclude that the pharmacokinetic and pharmacodynamic profiles of propofol after infusion were not markedly affected by renal failure.
引用
收藏
页码:854 / 860
页数:7
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