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- W2084571748 abstract "Onze patients ont bénéficié d'une résection endoscopique d'adénome prostatique et de tumeurs vésicales sous rachianesthésie à la péthidine 1 mg · kg−1. Une étude pharmacocinétique est réalisée. Il existe une résorption sanguine importante et rapide de la péthidine. La concentration plasmatique maximale moyenne (Cmax) est de 176±66 ng · ml−1 (extrêmes : 84–208 ng · ml−1). Le temps nécessaire à l'apparition de la Cmax (Tmax) est de 2,3±1,4 h (extrêmes : 0,5–6 h). La demi-vie d'élimination (t ½ β) est de 7,2±2,2 h (extrêmes : 4–11,5 h). Les concentrations sanguines sont a priori insuffisantes pour expliquer l'analgésie postopératoire d'origine systémique car les concentrations thérapeutiques se situent à 500–700 ng · ml−1. Seuls deux patients ont nécessité un complément d'analgésie aux 8e et 12e heures. Il n'y a pas eu de dépression respiratoire immédiate ou retardée. La péthidine à la dose de 1 mg · kg−1 par voie intrathécale permet donc la chirurgie sous-ombilicale, mais l'analgésie postopératoire est surtout en rapport avec l'existence de récepteurs morphiniques médullaires. Ces résultats pharmacocinétiques incitent à proposer aux patients bénéficiant de ce type d'anesthésie une surveillance rigoureuse de 24 h. Eleven male patients undergoing endoscopic resection for prostatic adenoma and bladder tumours under spinal anaesthesia received intrathecal pathidine 1 mg · kg−1. Plasma concentration and its evolution with time were assessed; pethidine plasma concentrations were determined by high performance liquid chromatography. Pethidine was rapidly and extensively absorbed. The peak plasma concentration of pethidine was 176±66 ng · ml−1 (range : 84–208) and the time to peak concentration was 2.3±1.4 h (range : 0.5–6 h). The terminal elimination half-life was 7.2±2.2 h (range : 4–11.5 h). The plasma concentrations of pethidine remained below 500–700 ng · ml−1, the minimum concentration necessary to obtain a systemic analgesic effect. Two patients required noramidopyrine as a complement at the 8th and 12th h respectively. No respiratory depression was observed. Intrathecal pethidine (1 mg · kg−1) was an effective agent for spinal anaesthesia : the prolonged postoperative analgesia was due to the drug acting on opioid receptors in the spinal cord. This led to the necessity of postoperative monitoring during 24 h after intrathecal pethidine administration." @default.
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- W2084571748 date "1987-01-01" @default.
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- W2084571748 title "Pharmacocinétique de la péthidine après rachianesthésie. Implications cliniques" @default.
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- W2084571748 doi "https://doi.org/10.1016/s0750-7658(87)80007-2" @default.
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