Zhang Y, Hu X, Zhnag Y
Department of Anesthesia, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037.
Zhonghua Yi Xue Za Zhi. 1999 Mar;79(3):187-9.
To determine the interaction between fentanyl and sevoflurane following a bolus injection of fentanyl after induction iwth sevoflurane inhalation only.
Sixty children aged 5-10 years who were diagnosed as having VSD or ASD were randomly allocated into three groups. The first group received sevoflurane in oxygen without any other drugs. The second group received sevoflurane in oxygen with fentanyl 3 ng/kg, and the third group received sevoflurane in oxygen with fentanyl 6 ng/kg. MAC determination, in response to the stimulus of skin incision, was made using the "up-down" method.
The MAC of sevoflurane in oxygen was (2.72 +/- 0.08)%. Fentanyl 3 ng/kg bolus injection produced a fentanyl plasma concentration of (0.64 +/- 0.13) microgram/L at skin incision and resulted in a MAC for sevoflurane of (1.03 +/- 0.07)%. Fentanyl 6 ng/kg bolus injection produced a fentanyl plasma concentration of (1.51 +/- 0.18) micrograms/L at skin incision and resulted in a MAC for sevoflurane of (0.64 +/- 0.01)%. By the stimulation of skin incision, the Hr, MAP of group I increased 39%, 29%, compared with group II 14%, 15%, group III 20%, 14%, respectively. These results were significantly different (P < 0.01).
The MAC of sevoflurane is significantly reduced 20 minutes after a single dose of 3 ng/kg of fentanyl and that increasing the fentanyl dose to 6 ng/kg produces a little further decrease in MAC of sevoflurane.
仅在七氟醚吸入诱导后静脉推注芬太尼，以确定芬太尼与七氟醚之间的相互作用。
将60例5-10岁诊断为室间隔缺损（VSD）或房间隔缺损（ASD）的儿童随机分为三组。第一组仅接受氧气中的七氟醚，无其他药物。第二组接受氧气中的七氟醚加3 ng/kg芬太尼，第三组接受氧气中的七氟醚加6 ng/kg芬太尼。采用“上-下”法，根据皮肤切口刺激进行最低肺泡有效浓度（MAC）测定。
氧气中七氟醚的MAC为（2.72±0.08）%。静脉推注3 ng/kg芬太尼在皮肤切口时产生的芬太尼血浆浓度为（0.64±0.13）μg/L，七氟醚的MAC为（1.03±0.07）%。静脉推注6 ng/kg芬太尼在皮肤切口时产生的芬太尼血浆浓度为（1.51±0.18）μg/L，七氟醚的MAC为（0.64±0.01）%。通过皮肤切口刺激，与第二组相比，第一组的心率（Hr）、平均动脉压（MAP）分别升高39%、29%，第二组分别升高14%、15%，第三组分别升高20%、14%。这些结果有显著差异（P<0.01）。
单次给予3 ng/kg芬太尼20分钟后，七氟醚的MAC显著降低，将芬太尼剂量增加至6 ng/kg会使七氟醚的MAC进一步略有降低。
