Thomson I R, Hudson R J, Rosenbloom M, Meatherall R C
Can J Anaesth. 1987 May;34(3 ( Pt 1)):227-32. doi: 10.1007/BF03015157.
Using a randomized double-blind protocol the authors compared two narcotic anaesthetic regimens in 33 patients with good ventricular function undergoing coronary artery surgery. After premedication with morphine and scopolamine, patients received either fentanyl 100 micrograms X kg-1 (n = 16), or sufentanil 15 micrograms X kg-1 (n = 17), intravenously (IV) over 10 min to induce anaesthesia. Metocurine 0.42 mg X kg-1 provided muscle relaxation. No further IV anaesthetic agents were given. The haemodynamic response to induction, intubation, and surgery, differed minimally between agents. The degree of rigidity on induction was identical with both agents, as were the intervals following induction at which patients lost consciousness, regained consciousness, or met criteria for extubation. However, the interval until extubation criteria were met did correlate with the duration of cardiopulmonary bypass. Sufentanil 15 micrograms X kg-1, was clinically indistinguishable from fentanyl 100 micrograms X kg-1, when used as the primary anaesthetic agent for coronary surgery.
作者采用随机双盲方案,对33例心室功能良好、接受冠状动脉手术的患者的两种麻醉方案进行了比较。在使用吗啡和东莨菪碱进行术前用药后,患者分别接受静脉注射(IV)10分钟的100微克/千克芬太尼(n = 16)或15微克/千克舒芬太尼(n = 17)以诱导麻醉。0.42毫克/千克的美托咪定提供肌肉松弛作用。未给予其他静脉麻醉剂。两种药物在诱导、插管及手术过程中的血流动力学反应差异极小。诱导时的强直程度在两种药物组中相同,患者失去意识、恢复意识或达到拔管标准的诱导后间隔时间也是如此。然而,直至达到拔管标准的间隔时间确实与体外循环时间相关。当用作冠状动脉手术的主要麻醉剂时,15微克/千克的舒芬太尼在临床上与100微克/千克的芬太尼无法区分。