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地西泮或硫喷妥钠用于全身麻醉诱导:心肺效应比较

Induction of general anesthesia with diazepam or thiopental: a comparison of the cardiorespiratory effects.

作者信息

Rubin A, Allen G D, Everett G B

出版信息

Anesth Prog. 1978 Mar-Apr;25(2):39-44.

Abstract

Detailed cardiorespiratory studies were performed in 10 volunteers in whom general anesthesia was induced with thiopental 3 mg/kg and diazepam 0.4 mg/kg.Minimal changes in blood pressure were noted with both agents. Depression of total peripheral resistance lasted in excess of 20 minutes with diazepam but had returned to control levels with thiopental, elevations in cardiac rate and output were most evident and lasted longer with diazepam. In the healthy volunteer induction of anesthesia with diazepam causes alterations in cardiovascular parameters which are more profound than with thiopental. The data presented is in contrast to that obtained when patients with cariovascular disease are studied.With diazepam, considerable individual variation and long recovery times were confirmed.Following extensive clinical use, a detailed study demonstrated minimal cardiovascular depression following intravenous induction of sedation with diazepam, in patients who had prior cardiovascular disease. Subsequent studies suggested that diazepam would be a more suitable alternative for induction of general anesthesia in patients with cardiovascular disease. This was confirmed by Ikram and Rubin. It has been used extensively for sedative techniques in dentistry, and therefore it was logical to extend this concept to the induction of general anesthesia by intravenous diazepam. It was decided to evaluate the use of intravenous diazepam for induction of general anesthesia and to compare the detailed cardiovascular and respiratory effects of this drug with thiopental.

摘要

对10名志愿者进行了详细的心肺研究,这些志愿者采用3mg/kg硫喷妥钠和0.4mg/kg地西泮诱导全身麻醉。两种药物均使血压有轻微变化。地西泮使总外周阻力降低持续超过20分钟,但硫喷妥钠使总外周阻力已恢复至对照水平;地西泮使心率和心输出量升高最为明显且持续时间更长。在健康志愿者中,用地西泮诱导麻醉引起的心血管参数改变比硫喷妥钠更显著。所呈现的数据与对心血管疾病患者研究时获得的数据相反。用地西泮时,证实存在相当大的个体差异和较长的恢复时间。在广泛临床应用后,一项详细研究表明,对于既往有心血管疾病的患者,静脉注射地西泮诱导镇静后心血管抑制作用轻微。随后的研究提示,地西泮对于心血管疾病患者诱导全身麻醉是更合适的选择。这一点得到了伊克拉姆和鲁宾的证实。地西泮已广泛用于牙科的镇静技术,因此将这一概念扩展至静脉注射地西泮诱导全身麻醉是合理的。决定评估静脉注射地西泮用于诱导全身麻醉的效果,并将该药详细的心血管和呼吸效应与硫喷妥钠进行比较。

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