Plasma concentration and protein binding of alfentanil during highdose infusion for cardiac surgery

We have studied plasma protein binding of alfentanil in 10 patients given a mean total dose of 949 μg kg-−1 as the principal anaesthetic agent for coronary artery bypass grafting. The mean unbound fraction of plasma alfentanil increased from 0.09 to 0.16 after administration of heparin and to 0.26 a...

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 1994-05, Vol.72 (5), p.571-576
Main Authors: HYNYNEN, M., HYNNINEN, M., SOINI, H., NEUVONEN, P.J., HEINONEN, J.
Format: Article
Language:English
Subjects:
Analgesics
Analgesics, opioid: alfentanil
Heart. cardiopulmonary bypass
opioid: alfentanil
Pharmacodynamics
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Summary:We have studied plasma protein binding of alfentanil in 10 patients given a mean total dose of 949 μg kg-−1 as the principal anaesthetic agent for coronary artery bypass grafting. The mean unbound fraction of plasma alfentanil increased from 0.09 to 0.16 after administration of heparin and to 0.26 after beginning cardiopulmonary bypass (CPB). After CPB until the end of surgery, the unbound fraction decreased to 0.12. These changes in the unbound fraction were associated with significant changes in plasma total and unbound concentrations of alfentanil also. Within the first 1 min of CPB, total alfentanil concentration had decreased by more than the unbound concentration and the decrease observed in the latter disappeared rapidly. From induction of anaesthesia until awakening of the patient, plasma protein binding of alfentanil was related significantly (P = 0.0166) to the serum concentration of orosomucoid (α1-acid glycoprotein). (Br. J. Anaesth. 1994; 72: 571–576)
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/72.5.571