Download Cardiovascular Measurement in Anaesthesiology by C.-A. Andreae (auth.), Professor C. Prys-Roberts, Professor PDF

By C.-A. Andreae (auth.), Professor C. Prys-Roberts, Professor M. D. Vickers (eds.)

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The characteristics of fentanyl binding to plasma proteins of 15 healthy volunteers have been reported (1). The binding of alfentanil was studied in the same subjects by the same technique of eqUilibrium dialysis. g/ml. Partition of both drugs between red blood cells and plasma was studied in 15 (fentanyl) and five (alfentanil) normal subjects. 1. The pharmacokinetic characteristics of the two drugs are c(msistent with the difference in their lipid solubility. Total clearance of alfentanil is approximately one-sixth that of fentanyl, and may reflect a lower hepatic extraction ratio from whole blood.

The molar ratio of cross-reactivity of each drug in assay for the other was less than 10-4 in both cases. Weighted, least squares, non-linear regression analysis was used to fit a bi-exponential curve to each set of data, and the corresponding two-compartment open model was derived. Total clearance of each drug was calculated as the product V lk lO • At least 3 weeks later, two of the subjects were given 1 mg of alfentanil alone, and the analytical procedure was repeated as before. The results are summarized in Table 1.

Supplemantation with an anaesthetic agent Anaesthetic supplemantation Groups N 1. control (no fentanyl) 19 18 2. intramuscular fentanyl 14 9 5 3. s. Table 5. Fall in systolic blood pressure in per cent of initial value <30% Groups N 1. control (no fentanyl) 19 7 12 2. intramuscular fentanyl 14 5 9 3. s. >30% References 43 Discussion Subarachnoid or intramuscular injection of 50 Jlg of fentanyl did not affect the degree of analgesia obtained with 2 rnl of hyperbaric 5% lignocaine. The duration of sensory block was similar to those values obtained by Axelsson and Widman(3) who also used 5% hyperbaric lignocaine.

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