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目的探讨盐酸右美托咪定注射液在中国全麻肥胖患者的药代动力学特征。方法 8例肥胖患者全身麻醉后静脉泵注盐酸右美托咪定1.0μg·kg-1,高效液相色谱-质谱联用法(HPLC-MS/MS)测定血浆中右美托咪定浓度变化。以DAS 2.1.1软件进行数据处理,计算药代动力学参数。结果盐酸右美托咪定的药代动力学参数如下:Cmax为(3.33±1.20)μg·L-1,t1/2α为(2.49±0.56)min,t1/2β为(163.41±116.41)min,V1为(162.96±43.26)L,CLz(4.02±1.18)L·min-1,AUC0-t为(123.27±55.96)μg·min·L-1,MRT0-t为152.06min。肥胖患者的AUC、Cmax、CLz、V1较正常体质量患者均显著增大(P<0.05)。结论在肥胖患者临床麻醉中,给予右美托咪定负荷剂量时,应适当减少药物剂量;维持阶段时,应适当增加药物剂量。
Objective To investigate the pharmacokinetics of dexmedetomidine hydrochloride injection in obese patients under general anesthesia in China. Methods Eight obese patients underwent intravenous injection of dexmedetomidine 1.0 μg · kg -1 after general anesthesia. The plasma concentration of dexmedetomidine was determined by HPLC-MS / MS. Data was processed using DAS 2.1.1 software to calculate pharmacokinetic parameters. Results The pharmacokinetic parameters of dexmedetomidine hydrochloride were as follows: Cmax was (3.33 ± 1.20) μg · L-1, t1 / 2α was (2.49 ± 0.56) min and t1 / 2β was (163.41 ± 116.41) V1 was 162.96 ± 43.26 L, CLz was 4.02 ± 1.18 L · min-1, AUC0-t was (123.27 ± 55.96) μg · min · L-1, and MRT0-t was 152.06 min. AUC, Cmax, CLz and V1 in obese patients were significantly higher than those in normal subjects (P <0.05). Conclusions In the clinical anesthesia of obese patients, when dexmedetomidine is loaded, the dose of dexmedetomidine should be appropriately reduced; during the maintenance phase, the dose of dexmedetomidine should be appropriately increased.