Nonaka Akihiko, Suzuki Satomi, Abe Fumiaki, Masui Kenichi
Department of Anesthesia, Yamanashi Prefectural Central Hospital, Kofu 400-8506.
Masui. 2006 Aug;55(8):983-7.
Pentazocine may be an alternative for fentanyl during total intravenous anesthesia (TIVA) using propofol. The authors compared the efficacy and safety of pentazocine for analgesics in TIVA using propofol.
Eighty-nine patients scheduled for mastectomy were analyzed retrospectively. Patients were classified into two groups by used analgesics; pentazocine (Group P, n = 34) and fentanyl (Group F, n = 55). Anesthesia was induced with propofol, using target controlled infusion method, and ketamine 20-50 mg, and was maintained with propofol infusion and increments of fentanyl or single dose of pentazocine with 40% oxygen in air. Postoperative pain was assessed using a visual analogue pain scale (VAS).
There were no differences in the patient background between both groups. Systolic as well as diastolic blood pressure and heart rate were not different between both groups during surgery. The maintenance dose of propofol was not different between the two groups. Awakening time in about 80% of patients was within 15 minutes and is not different between the two groups. There were no differences between the two groups regarding VAS. There are no severe complications. Incidence of nausea and vomiting was not different between the two groups.
The results suggest that pentazocine would provide a stable hemodynamic state, rapid recovery and an effective postoperative pain relief to the same degree as with fentanyl in TIVA with propofol.
在使用丙泊酚的全静脉麻醉(TIVA)期间,喷他佐辛可能是芬太尼的替代药物。作者比较了喷他佐辛在使用丙泊酚的TIVA中作为镇痛药的疗效和安全性。
对89例计划行乳房切除术的患者进行回顾性分析。根据使用的镇痛药将患者分为两组;喷他佐辛组(P组,n = 34)和芬太尼组(F组,n = 55)。采用靶控输注法用丙泊酚诱导麻醉,并给予20 - 50 mg氯胺酮,然后用丙泊酚输注维持麻醉,并追加芬太尼或单次给予喷他佐辛,同时吸入含40%氧气的空气。术后疼痛采用视觉模拟疼痛量表(VAS)进行评估。
两组患者的背景无差异。手术期间两组患者的收缩压、舒张压和心率均无差异。两组丙泊酚的维持剂量无差异。约80%患者的苏醒时间在15分钟内,两组之间无差异。两组在VAS方面无差异。无严重并发症。两组恶心呕吐的发生率无差异。
结果表明,在使用丙泊酚的TIVA中,喷他佐辛与芬太尼一样,能提供稳定的血流动力学状态、快速恢复以及有效的术后疼痛缓解。