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氟马西尼逆转地西泮呼吸效应的临床研究

[Clinical investigation of flumazenil in reversing the respiratory effects of diazepam].

作者信息

Doi M, Ikeda K

机构信息

Department of Anesthesiology and Critical Care Medicine, Hamamatsu University School of Medicine.

出版信息

Masui. 1990 Oct;39(10):1377-82.

PMID:2255045
Abstract

Eight patients (ASA I-II) scheduled for a minor surgery under lumbar epidural or spinal anesthesia were studied. The patients were sedated with approximately 0.2 mg.kg-1 of bolus injection followed by 0.2 mg.kg-1.min-1 of continuous infusion of diazepam. In order to evaluate the reversing effects of 0.2 mg of flumazenil on the respiratory effects of diazepam, the following parameters were examined at three points, namely 1) control period, 2) during infusion of diazepam, and 3) ten minutes following injection of flumazenil; tidal volume, respiratory frequency, minute volume, inspiratory time/total time of breath (Tl/Tt) and %RC with a respiratory inductive plethysmograph, ventilatory response to carbon dioxide using a modified Read's rebreathing method. We found that with flumazenil, tidal volume and the slope of the ventilatory response curve to carbon dioxide increased and arterial carbon dioxide tension decreased. However, minute volume, respiratory frequency, Tl/Tt and %RC were unchanged with flumazenil. Flumazenil did not change other clinical features and did not produce any abnormal data in laboratory examination. We conclude that flumazenil reverses the respiratory effects of diazepam at least for ten minutes following its injection without producing any complications and side effects.

摘要

对八名计划在腰段硬膜外或脊髓麻醉下进行小手术的患者(ASA I-II级)进行了研究。患者先静脉推注约0.2mg/kg的地西泮,随后以0.2mg/kg·min⁻¹的速度持续输注地西泮进行镇静。为了评估0.2mg氟马西尼对地西泮呼吸效应的逆转作用,在三个时间点检测了以下参数:1)对照期;2)地西泮输注期间;3)注射氟马西尼后十分钟。使用呼吸感应体积描记仪测量潮气量、呼吸频率、分钟通气量、吸气时间/呼吸总时间(TI/Tt)和呼吸顺应性百分比(%RC),采用改良的里德再呼吸法测量对二氧化碳的通气反应。我们发现,使用氟马西尼后,潮气量和对二氧化碳的通气反应曲线斜率增加,动脉血二氧化碳分压降低。然而,氟马西尼对分钟通气量、呼吸频率、TI/Tt和%RC没有影响。氟马西尼没有改变其他临床特征,实验室检查也未产生任何异常数据。我们得出结论,氟马西尼在注射后至少十分钟内可逆转地西泮的呼吸效应,且不会产生任何并发症和副作用。

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