摘要
目的:探讨氟马西尼是否可以拮抗异氟醚的麻醉残余作用,加速麻醉苏醒。方法:采用随机、双盲、对照方法,选择择期手术、年龄18～60岁、ASA分级Ⅰ～Ⅱ级且无术前用药患者60例,芬太尼3μg/kg、丙泊酚2mg/kg、维库溴胺0.1mg/kg诱导,异氟醚、芬太尼、维库溴胺维持麻醉。手术结束停止异氟醚的吸入,继续机械通气,当呼气末异氟醚浓度降至0.45%～0.5%时,分为3组,分别给予生理盐水(对照组)、氟马西尼0.5mg(0.5mg组)和氟马西尼1.0mg(1.0mg组)。每间隔1分钟进行1次意识评价,至患者定向力恢复。记录呼之睁眼、指令运动、正确回答问题、定向力恢复的时间,以及血压、脉搏、脑电双频指数(BIS)值、体温、呼气末异氟醚浓度、呼气末二氧化碳值。并在手术诱导前,定向力恢复时,定向力恢复后15、30、60、120min分别给患者出示一张不同的图片,术后24h随访患者对图片的记忆情况。结果:患者的一般情况差异无显著性(P>0.05)。对照组、0.5mg组和1.0mg组患者从停止吸入异氟醚至指令运动恢复时间分别为(19.58±6.91)min、(22.05±9.19)min和(20.32±6.44)min(P=0.5919),从停止吸入异氟醚至定向力恢复的时间分别为(24.68±8.09)min、(26.47±10.72)min和(22.47±10.90)min(P=0.5340)。3组患者各时间点对图片的正确辨识率差异均无显著性(P>0.05)。结论:术毕静脉注射0.5mg、1.0mg氟马西尼未能拮抗异氟醚的残余麻醉作用。氟马西尼对于异氟醚麻醉术后短时间的记忆损害(顺行性遗忘)无明显影响。
Objective To investigate whether flumazenil can antagonize isoflurane＇s residual anesthetic effect. Methods Sixty patients scheduled for elective surgery under isoflurane general anesthesia were randomly allocated into three groups to receive flumazenil 0.5 mg, 1.0 mg or an equal volume of normal saline, respectively, during anesthetic recovery period. No perimedincation were given in all patients. Anesthesia was induced with fentanyl 3μg/kg, propofol 2 mg/kg and vecuronium 0.1 mg/kg, and maintained with isoflurane, fentanyl and vecuronium. When skin was closed, the isoflurane was terminated. When end-expired isoflurane concentration decreased to 0.45% ± 0.50%, the test drug was given. Heart rate, blood pressure, body temperature, isoflurane concentration, bispectral index, and end-expired carbon dioxide were measured at different points during and after operation. The recovery times to eye-opening, command-movement, correct question-answering and orientation and anesthetic adverse events during the recovery were recorded. Six different pictures were shown to patients before induction, orientation recovery, and 15 min, 30 min, 60 min, 120 min. Test the memory 24 hours after orientation recovery. Results The demographic data were no significant differences among the three groups. The times from isoflurane termination to command-movement were （19.58 ± 6.91 ） min, （22.05±9.19）min and （20.32± 6.44） min （P= 0.591 9）, to orientation recovery were （24.68 ± 8.09） min, （26.47 ± 10.72） min and （22.47 ± 10.90） min （P = 0.534 0） in normal saline, flumazenil 0.5 mg and flumazenil 1.0 mg group respectively. There were no significant difference of the incidence of the pictures recognized correctly among three groups. Conclusions Neither intravenous flumazenil 0.5 mg nor 1.0 mg can antagonize isoflurane＇s residual anesthetic effect. Flumazenil can not influence the impaired memory caused by isoflurane anesthesia.
出处
《实用医学杂志》
CAS
北大核心
2009年第4期621-623,共3页
The Journal of Practical Medicine
关键词
氟马西尼
异氟醚
麻醉
麻醉品拮抗药
Flumazenil
Isoflurane
Anesthesia
Narcotic antagonists
