No abstract

Alfentanil disposition after an intravenous bolus of 50 micrograms/kg was followed in 15 elderly surgical patients and was compared to that in nine young adults. A two-compartment open model described alfentanil disappearance from plasma. Apparent volumes of distribution of the central compartment (201 and 211 ml/kg; means), at steady state (460 and 543 ml/kg), and of the AUC (746 and 722 ml/kg) in young adults and in elderly subjects did not differ. Plasma clearance was lower in elderly subjects (4.4 ml/min/kg) than in young adults (6.5 ml/min/kg), whereas terminal plasma t1/2 was longer in the elderly patients (137 and 83 min). Alfentanil dosage should therefore be reduced in elderly patients when large single doses, multiple doses, or long-term infusions are required.

min-t pour une dose de charge qui fut plus tard diminuEe aprEs dix minutes ~ une dose de I Izg" kg -t " mhz -I , du bromure de vecuronium aprEs l' induction de I'anesthEsie une perfusion de propofol de 2 rag. kg -I . hr -I fut commencde pour le groupe A, 3 mg " kg -I " hr -I pour le groupe Bet 4 rag. kg -t . hr -t pour le groupe C. Aux signes d'une anesthdsie IEgEre des bolus supplEmentaires de propofol 20 mg et d'alfentanil Img furent administrEs. Les patients furent ventiUEs avec de l' oxyg~ne-air (FtOz 0,35). Les pressions moyennes systoliques et diastoliques n'ont pas dEmontrE de difference statistiquement significative entre les trois groupes. Une diminution significative (P < 0,01) des pressions moyennes systoliques et diastoliques Etait observ~e apr~s l'induction de l'anesthEsie et l'intubation endotrachEale. Le rEveil fut sans complication chez tousles patients sauf un qui a ddmontrE une depression respiratoire rEpondant au naloxone (0,2 mg IVIn the last few years much attention has been paid to the search for new techniques of total intravenous anaesthesia. These techniques would avoid the use of inhalational anaesthetics, including nitrous oxide, which might be harmful to patients, anaesthesists and other workers in an operating theatre. ~,2 New shortacting hypnotics and analgesics are available with a wide therapeutic ratio which show little accumulation and which are suitable for continuous infusion.