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


Miller, RS and Peterson, GM and McLean, SR and Moller, C, Effect of cardiopulmonary bypass on the plasma concentrations of fentanyl and alcuronium, Journal of Clinical Pharmacy and Therapeutics, 22, (3) pp. 197-205. ISSN 1365-2710 (1997) [Refereed Article]

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DOI: doi:10.1046/j.1365-2710.1997.94875948.x


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򊣏1% and 47񶤚% for total concentrations of fentanyl in plasma and haemoglobin in blood, respectively. The magnitude of these reductions in individual patients was significantly related (Spearman |gr=065, P<005). The unbound fraction of fentanyl rose from 023 to 034 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 |gr=085, P<001). The estimated elimination half-life of fentanyl using the grouped data was 47 h. The total alcuronium concentration in plasma fell by 29% on initiation of CPB and there was no increase on rewarming. The estimated elimination half-life of alcuronium using the grouped data was 234 min. Despite marked declines in the plasma concentrations of both drugs on initiation of CPB, suitable levels of anaesthesia were maintained throughout the procedure.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Anaesthesiology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Miller, RS (Mrs Rachel Susan Miller)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:McLean, SR (Professor Stuart McLean)
ID Code:11552
Year Published:1997
Web of Science® Times Cited:5
Deposited By:Pharmacy
Deposited On:1997-08-01
Last Modified:2011-06-01

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