Adachi Yushi, Suzuki Katsumi, Obata Yukako, Doi Matsuyuki, Sato Shigehito
Intensive Care Unit of University Hospital, Hamamatsu University School of Medicine, Hamamatsu 431-3192.
Masui. 2008 Jul;57(7):901-3.
An 83-year-old female patient was managed in intensive care unit postoperatively with artificial ventilation and propofol-based sedation. On the second postoperative day, we tried to remove an endotracheal tube. Naloxone was administered to the patient for reversing the sedative effect of fentanyl infused intraoperatively. Her consciousness level was improved; however, subsequent administration of flumazenil induced hypnosis. Benzodiazepine-like partial agonistic effect of flumazenil might have enhanced residual hypnotic effect of propofol. Administration of flumazenil to the patient infused with propofol should be done cautiously for awakening the patient from anesthesia.
一名83岁女性患者术后在重症监护病房接受人工通气和丙泊酚镇静治疗。术后第二天,我们尝试拔除气管插管。给予患者纳洛酮以逆转术中输注芬太尼的镇静作用。她的意识水平有所改善;然而,随后给予氟马西尼却诱发了催眠状态。氟马西尼的苯二氮䓬类部分激动作用可能增强了丙泊酚的残余催眠作用。对于接受丙泊酚输注的患者,在使其从麻醉中苏醒时应谨慎给予氟马西尼。