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低剂量布托啡诺联合地西泮在腰麻-硬膜外联合麻醉(H型麻醉)期间的镇静效果

[The sedative effects of a low dose of butorphanol combined with diazepam during spinal-epidural anesthesia (H-type anesthesia)].

作者信息

Sugiyama A, Hanaoka K, Hiraishi T, Ide Y, Yajima C, Abe Y

出版信息

Masui. 1989 Sep;38(9):1161-5.

PMID:2810712
Abstract

The sedative effects of the low dose of butorphanol combined with diazepam during spinal-epidural (H-type) anesthesia were studied in 20 urological or gynecological patients of ASA class I or II. Patients were premedicated with 0.5mg of atropine sulfate and 50mg of hydroxyzine hydrochloride 1 hour before the operation. Spinal anesthesia was performed with 2.4 ml of 0.3% dibucaine or 2.5 ml of 3% lidocaine and if necessary 1-2% mepivacaine was administered via the catheter for maintenance of the epidural anesthesia. Butorphanol 0.5 mg and diazepam 5 mg were administered intravenously after the establishment of spinal anesthesia. We observed the condition of sedative effects, the changes in blood pressure, heart rate and respiratory rate, before the administration of butorphanol, 2 and 5 minutes after the administration of the drug and then every 5 minutes until the recovery was noticed. We found that the sedative effects of butorphanol combined with diazepam were clinically sufficient. Patients were sleeping for 40 minutes and then drowsy for 30 minutes with sufficient sedation. There was no complication except slight respiratory suppression. Our results suggest that the butorphanol combined with diazepam is a useful method for the sedation during spinal-epidural anesthesia.

摘要

在20例ASA I或II级的泌尿外科或妇科患者中,研究了低剂量布托啡诺联合地西泮在腰麻-硬膜外联合(H型)麻醉期间的镇静效果。患者在手术前1小时用0.5mg硫酸阿托品和50mg盐酸羟嗪进行术前用药。腰麻采用2.4ml 0.3%丁卡因或2.5ml 3%利多卡因进行,必要时通过导管给予1-2%甲哌卡因以维持硬膜外麻醉。在腰麻建立后,静脉注射0.5mg布托啡诺和5mg地西泮。我们观察了布托啡诺给药前、给药后2分钟和5分钟以及之后每5分钟直至观察到恢复时的镇静效果、血压、心率和呼吸频率的变化。我们发现布托啡诺联合地西泮的镇静效果在临床上是足够的。患者睡眠40分钟,然后嗜睡30分钟,镇静效果良好。除轻微呼吸抑制外,无并发症发生。我们的结果表明,布托啡诺联合地西泮是腰麻-硬膜外联合麻醉期间一种有用的镇静方法。

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