Klein D S, Klein P W, Mahaley M S
J Neurooncol. 1986;3(4):323-5. doi: 10.1007/BF00165580.
A therapeutic regimen is described for sedative, analgesic, and anti-emetic effect in patients receiving intra-arterial carmustine (BCNU) for malignant gliomas. This regimen consists of nalbuphine, 30 mg, i.v., and droperidol, 2.5 mg, i.v., given immediately prior to intra-carotid BCNU infusion. Droperidol, 2.5 mg, i.v., is then administered on four hour intervals for sixteen hours post-procedure. This combination provided excellent effect in nine patients treated for twelve intra-carotid infusions. None of the nine patients experienced vomiting, one experienced mild nausea several hours post-infusion, and non complained of severe pain or discomfort. Thirteen additional patients received diazepam, 10 mg, P.O., prior to the intra-carotid BCNU infusion, with fentanyl, 100 mcg, i.v., and prochlorperazine, 10 mg, i.m. at the onset of infusion. All thirteen patients suffered from severe nausea, vomiting, and orbital pain. The nalbuphine/droperidol combination is thought to provide a superior alternative to the traditional narcotic/pheonothiazine/benzodiazepine combination for carotid BCNU infusion. This combination has theoretical advantages for the patient with intracranial mass lesions by providing analgesia and sedation with minimal potential for respiratory depression and carbon dioxide retention.
本文描述了一种治疗方案，用于在接受动脉内卡莫司汀（BCNU）治疗恶性胶质瘤的患者中产生镇静、镇痛和止吐作用。该方案包括在颈内动脉输注BCNU之前立即静脉注射30毫克纳布啡和2.5毫克氟哌利多。然后在术后16小时内每隔4小时静脉注射2.5毫克氟哌利多。这种联合用药在9例接受12次颈内动脉输注治疗的患者中效果极佳。9例患者均未出现呕吐，1例在输注后数小时出现轻度恶心，且均未主诉严重疼痛或不适。另外13例患者在颈内动脉输注BCNU之前口服10毫克地西泮，并在输注开始时静脉注射100微克芬太尼和肌肉注射10毫克丙氯拉嗪。所有13例患者均出现严重恶心、呕吐和眼眶疼痛。纳布啡/氟哌利多联合用药被认为是颈内动脉输注BCNU时传统麻醉药/吩噻嗪类/苯二氮䓬类联合用药的更佳替代方案。这种联合用药通过提供镇痛和镇静作用，且呼吸抑制和二氧化碳潴留的可能性最小，对患有颅内占位性病变的患者具有理论优势。
