Cheng D C, Chung F, Chapman K R, Romanelli J
Department of Anaesthesia, University of Toronto, Ontario, Canada.
Can J Anaesth. 1990 Jul;37(5):521-7. doi: 10.1007/BF03006319.
This randomized double-blind study compared the effects of: (1) saline infusion (C); (2) sufentanil alone (1.0 micrograms.kg-1) (S); and (3) low-dose sufentanil (0.5 micrograms.kg-1) in combination with lidocaine (1.5 mg.kg-1) (LS): on the cardiovascular responses to tracheal intubation and on postoperative ventilation as monitored by respiratory inductive plethysmography in day-care surgical procedures of approximately 60 min duration. Thirty healthy, unpremedicated patients were studied. Thiopentone requirements were reduced by 40 and 28 per cent in the S and LS groups respectively compared with control (P less than 0.001). Both treatments suppressed HR and BP responses (P less than 0.005) to intubation. Postoperatively, PaCO2 was elevated (P less than 0.05) in group S. Dose-related respiratory depression was observed. The incidence of postoperative apnoea was significantly higher in both S and LS groups than compared with control (P less than 0.05). However, only patients in group S showed higher apnoea index and mean apnoea duration over the initial 10-20 min after surgery compared with control (P less than 0.005). In addition, group S showed slower respiratory frequency and prolonged expiratory time (P less than 0.005). In conclusion, an induction dose of sufentanil (1 microgram.kg-1) used in balanced anaesthesia of less than 70 min duration was associated with significant respiratory depression, particularly during the initial 10-20 min after surgery, whereas low-dose sufentanil (0.5 micrograms.kg-1) with lidocaine (1.5 mg.kg-1) had minimal postoperative respiratory depression and comparable attenuation of pressor responses to intubation.
（1）输注生理盐水（C）；（2）单独使用舒芬太尼（1.0微克·千克⁻¹）（S）；以及（3）低剂量舒芬太尼（0.5微克·千克⁻¹）与利多卡因（1.5毫克·千克⁻¹）联合使用（LS）：对约60分钟日间手术中气管插管的心血管反应以及通过呼吸感应体积描记法监测的术后通气的影响。研究了30名健康、未使用术前药的患者。与对照组相比，S组和LS组的硫喷妥钠需求量分别降低了40%和28%（P<0.001）。两种治疗方法均抑制了插管时的心率和血压反应（P<0.005）。术后，S组的动脉血二氧化碳分压升高（P<0.05）。观察到剂量相关的呼吸抑制。S组和LS组术后呼吸暂停的发生率均显著高于对照组（P<0.05）。然而，与对照组相比，仅S组患者在术后最初10 - 20分钟内显示出更高的呼吸暂停指数和平均呼吸暂停持续时间（P<0.005）。此外，S组的呼吸频率较慢且呼气时间延长（P<0.005）。总之，在持续时间小于70分钟的平衡麻醉中使用诱导剂量的舒芬太尼（1微克·千克⁻¹）与显著的呼吸抑制相关，尤其是在术后最初10 - 20分钟内，而低剂量舒芬太尼（0.5微克·千克⁻¹）与利多卡因（1.5毫克·千克⁻¹）联合使用术后呼吸抑制最小，且对插管时升压反应的减弱效果相当。
