PMID: 9447475Jun 1, 1997Paper

Effect of cardiopulmonary bypass on the plasma concentrations of fentanyl and alcuronium

Journal of Clinical Pharmacy and Therapeutics
R S MillerC Möller

Abstract

This study was conducted to examine the effect of cardiopulmonary bypass surgery on the total and unbound plasma concentrations of fentanyl and the total plasma concentrations of alcuronium. Total fentanyl concentrations were measured by gas chromatography, the plasma protein binding of fentanyl by ultrafiltration, and alcuronium concentrations by high-performance liquid chromatography. Sixteen patients were studied. On initiation of cardiopulmonary bypass (CPB), there were mean decreases of 58.8 +/- 7.1% and 47 +/- 3.2% for total concentrations of fentanyl in plasma and haemoglobin in blood, respectively. The magnitude of these reductions in individual patients was significantly related (Spearman p = 0.65, P < 0.05). The unbound fraction of fentanyl rose from 0.23 to 0.34 after the start of CPB. The total fentanyl concentration remained relatively stable during bypass until near the end of CPB when the mean total concentration increased, coinciding with rewarming. The size of the increase was related to the body mass index (BMI) of the patient (Spearman p = 0.85, P < 0.01). The estimated elimination half-life of fentanyl using the grouped data was 4.7 h. The total alcuronium concentration in plasma fell by 29% on initiation of...Continue Reading

Citations

Feb 21, 2002·Journal of Cardiothoracic and Vascular Anesthesia·Richard I Hall
Nov 1, 2001·Journal of Cardiothoracic and Vascular Anesthesia·J C LundellJ F Butterworth
Dec 20, 2017·Drug Metabolism Reviews·Santosh Kumar Sreevatsav AdirajuSussan Ghassabian
Aug 21, 2021·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Michael T KuntzViviane G Nasr

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