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British Journal of Anaesthesia, 1992, Vol. 69, No. 5 447-450
© 1992 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

DISPOSITION OF ALFENTANIL IN BURNS PATIENTS

A. G. MACFIE, M.B, CH.B, B.SC., D.R.C.O.G., F.R.C.ANAES.*, A. D. MAGIDES, M.B., CH.B., F.R.C.ANAES. and C. S. REILLY, M.D., F.R.C.ANAES.1

Department of Anaesthesia, University of Sheffield Beech Hill Road, Sheffield S10 2RX

1Correspondence to C.S.R.

We have studied the disposition of alfentanil in six patients (who had suffered 10–30% surface area burns 5–21 days previously) undergoing surgical debridement and grafting and compared the data with those from a control group of six patients matched for age, sex and weight undergoing body surface surgery of similar duration. Plasma samples were collected up to 480 min after an i. v. bolus of alfentanil 50 fig kg–1. Drug concentrations were measured by radioimmunoassay and alfentanil binding to plasma proteins by equilibrium dialysis. The burns patients had significantly greater concentrations of alpha-1-acid glycoprotein (AAG) and smaller concentrations of albumin. The mean protein binding of alfentanil was 94.2 (SEM 0.05)% in the burns group and 90.7 (0.4)% in the control group (P = 0.004). There was a good correlation between AAG concentration and protein binding (r= 0.8). The volume of distribution and total clearance of alfentanil were reduced significantly in the burns group. The clearance of the raction and the elimination half-life of alfentanil were not decreased significantly. (Br. J. Anaesth. 1992; 69: 447–450)

*Present address: Department of Anaesthesia, Western Infirmary, Dumbarton Road, Glasgow Gil 6NT.


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