title: Pharmacokinetics of sufentanil in patients undergoing coronary artery bypass graft surgery.
abstract: OBJECTIVE
  To determine the pharmacokinetics of sufentanil in patients undergoing coronary artery bypass graft surgery.
  
  
  METHODS
  Prospective, multigroup study.
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Patients with good left ventricular function undergoing elective surgery (n = 103).
  
  
  METHODS
  Sufentanil was administered by target-controlled infusion, with target effect-site concentrations ranging from 0.4 to 4.5 ng/mL. Isoflurane was administered as required to maintain stable hemodynamics. Sufentanil pharmacokinetics were determined by population modeling. The potential effects of gender, weight, different premedications (lorazepam, morphine-scopolamine, or clonidine), and coinduction with propofol on sufentanil pharmacokinetics were explored.
  
  
  RESULTS
  The first model determined was a simple 3-compartment model, without any covariates, which had these parameters: V(1) = 5.7 L, V(2) = 18.1 L, V(3) = 225 L, Cl(1) = 0.69 L/min, Cl(2) = 3.1 L/min, and Cl(3) = 1.4 L/min. The overall predictive ability during the entire pre-cardiopulmonary bypass period of this model was excellent, with virtually no bias (median prediction error, -0.4%) and good precision (median absolute prediction error, 18.4%). More complex models with the various premedications used or coinduction with propofol as covariates did not improve the predictive accuracy or precision compared with the simple 3-compartment model. Similarly, including either gender or weight as a covariate did not improve predictive ability.
  
  
  CONCLUSIONS
  The authors have determined a pharmacokinetic model for sufentanil that can be used to maintain desired target concentrations of sufentanil before cardiopulmonary bypass, with a high degree of accuracy and acceptable variability. Concomitantly administered medications (lorazepam, morphine-scopolamine, clonidine, or propofol) do not appear to have any clinically important effects on distribution-phase sufentanil pharmacokinetics.
authors.affiliation: Department of Anesthesia, University of Manitoba, St. Boniface General Hospital, 409 Taché Avenue, Winnipeg, Manitoba, Canada R2H 2A6. rhudson@cc.umanitoba.ca
authors.forename: R J
authors.initials: RJ
authors.lastname: Hudson
authors.forename: B T
authors.initials: BT
authors.lastname: Henderson
authors.forename: I R
authors.initials: IR
authors.lastname: Thomson
authors.forename: M
authors.initials: M
authors.lastname: Moon
authors.forename: M D
authors.initials: MD
authors.lastname: Peterson
mesh_terms: D000368:Aged; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011229:Preanesthetic Medication; D011446:Prospective Studies; D017409:Sufentanil / Q000494:pharmacology*
chemical_list: D018686:Anesthetics, Intravenous; D017409:Sufentanil