Stanley T H, Leiman B C, Rawal N, Marcus M A, van den Nieuwenhuyzen M, Walford A, Cronau L H, Pace N L
Department of Anesthesiology, University of Utah, Salt Lake City 84132.
Anesth Analg. 1989 Sep;69(3):328-35.
The authors compared the safety, efficacy, and effects on gastric volume and pH of oral transmucosal fentanyl citrate (OTFC) premedication and of placebo lollipop and no premedication in 55 children undergoing elective operations. The patients were randomly assigned to receive no premedication (group A, N = 18); OTFC containing 15-20 micrograms/kg of fentanyl citrate (group B, N = 18); or a placebo lollipop (group C, N = 19). Activity (sedation) and anxiety scores, vital signs (including systolic and diastolic arterial blood pressures, heart and respiratory rates), and pulse oximetry determined oxygen saturation were measured before and at 10-min intervals after premedication until the patients were taken to the operating room. Gastric contents were aspirated via an orogastric tube and analyzed for volume and pH after induction of anesthesia. Quality of induction and recovery were evaluated using scoring schedules; recovery times were measured and side effects recorded. OTFC was readily accepted and provided levels of sedation and anxiolysis significantly greater after 10 min than after no premedication or the placebo lollipop. Arterial blood pressures, heart rate, and oxygen saturations were not different among the three groups. In patients given OTFC, respiratory rates were significantly lower after 10 min than they were in patients having no premedication.(ABSTRACT TRUNCATED AT 250 WORDS)
作者比较了口服黏膜芬太尼枸橼酸盐（OTFC）术前用药、安慰剂棒棒糖及未进行术前用药对55例择期手术儿童的安全性、有效性以及胃容量和pH值的影响。患者被随机分为未进行术前用药组（A组，N = 18）；含15 - 20微克/千克芬太尼枸橼酸盐的OTFC组（B组，N = 18）；或安慰剂棒棒糖组（C组，N = 19）。在术前用药前及用药后每隔10分钟测量活动（镇静）和焦虑评分、生命体征（包括收缩压和舒张压、心率和呼吸频率）以及脉搏血氧饱和度测定的氧饱和度，直至患者被送入手术室。麻醉诱导后经口胃管抽吸胃内容物并分析其容量和pH值。使用评分表评估诱导和恢复质量；测量恢复时间并记录副作用。OTFC很容易被接受，且用药10分钟后提供的镇静和抗焦虑水平明显高于未进行术前用药或使用安慰剂棒棒糖的情况。三组的动脉血压、心率和氧饱和度没有差异。接受OTFC的患者用药10分钟后的呼吸频率明显低于未进行术前用药的患者。（摘要截断于250字）
