Abstract:

Objective To observe the effects of dexmedetomidine on pharmacokinetics and hemodynamics of sufentanil in children with congenital heart disease. Methods A total of 167 children，ASA class Ⅱ，aged 3 to 36 months，receiving general anesthesia for cardiac interventional surgery were enrolled. All the subjects received propofol of 2 mg/kg，sufentanil of 0.3 μg/kg，and cisatracurium besilate of 0.2 mg/kg during anesthesia induction. In anesthesia maintenance ，group D was intravenously given dexmedetomidine with the first dose of 1 μ g/kg followed by a maintenance dose of 0.7 μg/（kg·h），and group P was given propofol of 8 mg/（kg·h）. The intraoper⁃ ative hemodynamic parameters and adverse reactions were recorded. Blood samples were collected at 5，10，20， 30，45，60，75，and 90 min after SUF administration by dilution sampling method. Plasma concentration of SUF was determined by UHPLC ⁃ MS/MS method，and pharmacokinetic parameters were calculated by the Phoenix WinNonlinTM software. Results The plasma concentration at 20，60，or 120 min was significantly higher in group P than in group D（P < 0.05）. The clearance rate was（28.59 ± 10.23）mL/（kg·min）in group D，which was signifi⁃ cantly higher than that in group P（20.78 ± 10.45）mL/（kg·min）（P < 0.05）. There were no significant differences between the two groups in the elimination half⁃life，area under curve，apparent volume of distribution，and mean residence time of sufentanil（P > 0.05）. The incidence of intraoperative adverse hemodynamic reactions were 23.8% in group D and 19.2% in group P（P > 0.05）. Conclusions Dexmedetomidine accelerates the clearance rate of sufentanil but does not increase the incidence of adverse reactions in children with congenital heart disease.

Key words:

 , dexmedetomidine, sufentanil, pharmacokinetics, pediatric, congenital heart disease