Hudson R J
Department of Anaesthesia, University of Manitoba, St. Boniface General Hospital, Winnipeg.
Can J Anaesth. 1990 Mar;37(2):255-7. doi: 10.1007/BF03005480.
Several cases of recurrent respiratory depression progressing to apnoea and unconsciousness after apparent recovery from sufentanil have been reported recently. Alfentanil has the shortest elimination half-time of the narcotics used in anaesthesia, suggesting that it should be the least likely to cause postoperative respiratory depression. A case of recurrent unconsciousness and respiratory arrest after apparent recovery from alfentanil-isoflurane-nitrous oxide anaesthesia is reported. A total dose of 137 micrograms.kg-1 alfentanil was given over a 3.25-hr period to a 45-year-old female undergoing partial gastrectomy. Naloxone, 0.16 mg IV, rapidly restored spontaneous ventilation and consciousness. This case demonstrates that apnoea and unconsciousness can also recur after apparent recovery from alfentanil. Recovery room personnel should be aware of this phenomenon. Earlier detection may permit treatment before apnoea occurs. Patients given narcotic-supplemented anaesthesia should be monitored by capnography and/or pulse oximetry in the early postoperative period.
最近有报道称，几例患者在舒芬太尼表面恢复后出现反复的呼吸抑制，进而发展为呼吸暂停和昏迷。阿芬太尼是麻醉中使用的麻醉药品中消除半衰期最短的，这表明它最不可能引起术后呼吸抑制。本文报道了一例在阿芬太尼-异氟烷-氧化亚氮麻醉表面恢复后出现反复昏迷和呼吸骤停的病例。在3.25小时内，对一名接受部分胃切除术的45岁女性总共给予了137微克·千克-1的阿芬太尼。静脉注射0.16毫克纳洛酮后，患者迅速恢复了自主通气和意识。该病例表明，阿芬太尼表面恢复后也可能再次出现呼吸暂停和昏迷。恢复室工作人员应意识到这一现象。早期发现可能有助于在呼吸暂停发生前进行治疗。接受补充麻醉剂麻醉的患者在术后早期应通过二氧化碳监测仪和/或脉搏血氧饱和度仪进行监测。
