Advances in Research on the Impact of Autologous Blood Transfusion on Plasma Concentrations of Anesthetic Drugs

doi:10.3969/j.issn.1671-2587.2025.01.017

JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE ›› 2025, Vol. 27 ›› Issue (1): 121-126.DOI: 10.3969/j.issn.1671-2587.2025.01.017

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Advances in Research on the Impact of Autologous Blood Transfusion on Plasma Concentrations of Anesthetic Drugs

WANG Jinhuo, GUO Jianrong

Department of Anesthesiology and Perioperative Medicine, Shanghai Gongli Hospital, Naval MillitaryMedical University, Shanghai 200135

Received:2024-07-19 Published:2025-02-25

Abstract

Abstract: Autologous blood transfusion technology serves as an efficacious solution to the clinical dilemma of blood supply and demand, as well as the challenges associated with transfusion therapy. The techniques encompass various methods, including preoperative hemodilution, intraoperative salvage, and blood storage. The core principle involves the reinfusion of the patient's own blood, which may have been banked in advance or retrieved post-hemorrhage, when transfusion is necessitated. The application of autologous blood transfusion in clinical practice has been widespread, and these techniques can markedly reduce the reliance on allogeneic blood, which not only minimizes the risks of allogeneic transfusion-related complications but also effectively circumvents the transmission of infectious diseases. Nevertheless, the implementation of autologous blood transfusion inevitably induces a cascade of pathophysiological alterations within the body. These changes have the potential to influence the pharmacodynamic profile of anesthetic agents administered during surgery, thereby impacting the process of postoperative recovery. This review focuses on recent advancements in the impact of different autologous blood transfusion techniques on the plasma concentrations of anesthetic drugs.

Key words: Autologous blood transfusion, Blood drug concentration, Anesthetic drugs

CLC Number:

R457.1

WANG Jinhuo, GUO Jianrong. Advances in Research on the Impact of Autologous Blood Transfusion on Plasma Concentrations of Anesthetic Drugs[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2025, 27(1): 121-126.

References

[1] DASCI M F,KOSE O,MAZA B F,et al.A secure blood-saving protocol for Jehovah's Witnesses in primary total hip replacement[J].Jt Dis Relat Surg,2024,35(1):12-19.
[2] ZHOU J.A review of the application of autologous blood transfusion[J].Rev Bras De Pesquisas Med E Biol,2016,49(9):e5493.
[3] LI Y C,CHEN J L,XIE H,et al.Effectiveness,safety and indications of acute normovolemic haemodilution in total knee arthroplasty[J].Sci Rep,2024,14(1):3298.
[4] WANG H,LIN C S,ZHANG W H,et al.Effect of acute hypervolemic hemodilution with bicarbonated Ringer's solution on perioperative S100β and NSE in elderly patients undergoing spine surgery[J].Biotechnol Genet Eng Rev,2023:1-13.
[5] 卢爱新,郭乃超,李永刚,等.脊柱患者急性非等容血液稀释的效果[J].实用医学杂志,2013,29(8):1366-1367.
[6] ESPER T,WEHNER M,MEINECKE C D,et al.Blood/Gas partition coefficients for isoflurane,sevoflurane,and desflurane in a clinically relevant patient population[J].Anesth Analg,2015,120(1):45-50.
[7] 周建新,刘进.不同年龄国人的吸入麻醉药血/气分配系数及决定因素[J].中华麻醉学杂志,1998,18(1):7-10.
[8] LIU Y Q,REN Y M,GAO H,et al.Blood lipid abnormality changes the rate of alveolar-capillary uptake of sevoflurane:a prospective,non-interventional,clinical study[J].Int J Clin Pharmacol Ther,2017,55(2):156-162.
[9] MOROHASHI T,ITAKURA S,SHIMOKAWA K I,et al.Anesthetic potency of intravenous infusion of 20% emulsified sevoflurane and effect on the blood-gas partition coefficient in dogs[J].Anesth Analg,2021,132(2):575-583.
[10] 周建新. 影响吸入麻醉药血/气分配系数的诸因素[J].国外医学麻醉学与复苏分册,1998,19(3):141-145.
[11] ZHOU J X,LIU Y Q,LIU J.Combined effect of hypothermia and crystalloid hemodilution on the solubility of volatile anesthetics in human blood[J].Chin Med J(Engl),2002,115(7):1014-1019.
[12] WALSH C T.Propofol:milk of Amnesia[J].Cell,2022,185(25):4861.
[13] TAKIZAWA E,TAKIZAWA D,HIRAOKA H,et al.Disposition and pharmacodynamics of propofol during isovolaemic haemorrhage followed by crystalloid resuscitation in humans[J].Br J Clin Pharmacol,2006,61(3):256-261.
[14] TAKIZAWA E,HIRAOKA H,TAKIZAWA D,et al.Changes in the effect of propofol in response to altered plasma protein binding during normothermic cardiopulmonary bypass[J].Br J Anaesth,2006,96(2):179-185.
[15] FROESE L,GOMEZ A,SAINBHI A S,et al.Optimal bispectral index exists in healthy patients undergoing general anesthesia:a validation study[J].J Clin Monit Comput,2024,38(4):791-802.
[16] DAHABA A A,RINNHOFER S,WANG G,et al.Influence of acute normovolaemic haemodilution on bispectral index monitoring and propofol dose requirements[J].Acta Anaesthesiol Scand,2008,52(6):815-820.
[17] LIU T,BAI Y,YIN L,et al.Effect of acute normovolemic hemodilution on anesthetic effect,plasma concentration,and recovery quality in elderly patients undergoing spinal surgery[J].BMC Geriatr,2023,23(1):689.
[18] 柳彤,徐佳明,王金伙,等.急性等容血液稀释自体血体外隔离期间血浆中麻醉药物浓度变化及回输后对麻醉效应的影响[J].中国临床药理学与治疗学,2023,28(4):413-418.
[19] BUDIC I,JEVTOVIC STOIMENOV T,PAVLOVIC D,et al.Clinical importance of potential genetic determinants affecting propofol pharmacokinetics and pharmacodynamics[J].Front Med,2022,9:809393.
[20] 尹磊,徐佳明,吴敬医,等.急性等容血液稀释自体血回输对老年骨科手术患者脑电双谱指数与肌松效应的影响[J].中国临床药理学与治疗学,2021,26(10):1153-1158.
[21] 何满,高峰,田玉科.急性非等容性血液稀释对靶控输注丙泊酚镇静深度的影响[J].临床麻醉学杂志,2012,28(9):837-840.
[22] 金运敏,岳云,吴安石,等.急性高容量血液稀释对患者靶控输注异丙酚时镇静深度的影响[J].中华麻醉学杂志,2007,27(2):129-132.
[23] 徐凯智,岳静玲,胡小琴.心内直视手术中急性血液稀释对大剂量芬太尼药代动力学的影响[J].中华麻醉学杂志,1999,19(10):603-605.
[24] JELEAZCOV C,SAARI T I,IHMSEN H,et al.Changes in total and unbound concentrations of sufentanil during target controlled infusion for cardiac surgery with cardiopulmonary bypass[J].Br J Anaesth,2012,109(5):698-706.
[25] DAHABA A A,WANG G,XU X,et al.Influence of acute normovolaemic haemodilution on the dose-response relationship and time course of action of cisatracurium besylate[J].Br J Anaesth,2007,98(3):342-346.
[26] DAHABA A A,SULJEVIC I,OETTL K,et al.Influence of acute normovolemic hemodilution on the pharmacokinetics of Cisatracurium Besylate[J].Minerva Anestesiol,2013,79(11):1238-1247.
[27] 袁晓红,郭建荣,金孝岠.血液稀释对顺式阿曲库铵药代学及药效学影响的研究[J].中国临床药理学与治疗学,2014,19(12):1365-1370.
[28] XUE F S,LIAO X,LIU J H,et al.Influence of acute normovolaemic haemodilution on the dose-response and time-course of action of atracurium[J].Acta Anaesthesiol Scand,2000,44(2):163-169.
[29] DAHABA A A,PERELMAN S I,MOSKOWITZ D M,et al.Influence of acute normovolaemic haemodilution on the dose-response relationship,time-course of action and pharmacokinetics of rocuronium bromide[J].Br J Anaesth,2006,97(4):482-488.
[30] 袁晓红,方军,郭建荣,等.急性高容血液稀释对不同剂量罗库溴铵肌松效应的影响[J].中国临床药理学与治疗学,2013,18(12):1396-1400.
[31] 张利平,顾振华.急性中度等容性血液稀释下泮库溴铵药代动力学研究[J].中华麻醉学杂志,1995,15(11):486-489.
[32] 程勇,郭建荣,任芹,等.急性等容血液稀释对老年患者米库氯铵药效学影响的研究[J].中国医药指南,2018,16(20):48-49.
[33] XUE F S,LIU J H,LIAO X,et al.The influence of acute normovolemic hemodilution on the dose-response and time course of action of vecuronium[J].Anesth Analg,1998,86(4):861-866.
[34] 李振洲,陈雅儒,郭建荣.回收式自体输血在恶性肿瘤患者手术中的应用及风险评估[J].中国输血杂志,2022,35(3):345-348.
[35] IWASAKI H,TAKAGI S,KITAJIMA O,et al.Plasma rocuronium concentration in cell salvage blood following cardiac surgery:a case series[J].J Clin Monit Comput,2022,36(4):1213-1217.
[36] WANG G,WANG J,ZHOU H B,et al.Impairment of recovery of muscle function by residual rocuronium after re-transfusion of intraoperative salvaged blood[J].Chin Med J,2014,127(5):821-824.
[37] 王佳,赵霞,周海滨,等.顺苯磺酸阿曲库铵不抑制患者接受术中血液回收后肌肉及呼吸功能的恢复:单中心前瞻性研究[J].协和医学杂志,2019,10(2):138-142.
[38] 段立双,王欢,周循,等.贮存式自体全血与单纯红细胞输注对家兔骨髓造血干细胞功能的影响[J].临床麻醉学杂志,2021,37(3):290-295.

Advances in Research on the Impact of Autologous Blood Transfusion on Plasma Concentrations of Anesthetic Drugs

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