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重症监护病房患者静脉注射丁丙诺啡的呼吸抑制作用。

The respiratory depressive effects of intravenous buprenorphine in patients in an intensive care unit.

作者信息

Downing J W, Goodwin N M, Hicks J

出版信息

S Afr Med J. 1979 Jun 16;55(25):1023-7.

PMID:483080
Abstract

Buprenorphine hydrochloride, a new, potent, long-acting synthetic opiate analgesic, with partial agonist-antagonist activity, was administered intravenously to two groups of patients in an intensive care unit. Arterial blood was drawn for blood gas analysis before (control) and at regular intervals after drug administration, to determine the effects of intravenous buprenorphine on respiration in critically ill patients, each acting as his or her own control. Intravenous buprenorphine 0,4 mg (group I -- 10 patients) caused a significant reduction in mean respiration rate and an increase in mean PaCO2, but did not alter heart rate, PaO2 or base excess values. Intravenous buprenorphine 0,2 mg (group II -- 10 patients) was associated with a less significant reduction in the rate of breathing and elevation of PaCO2. Both 0,4 mg and 0,2 mg buprenorphine produced effective relief of pain, sedation, and reduction in restlessness, and allayed anxiety. Our results suggest that intravenous buprenorphine 0,2 mg can be safely recommended for the prolonged relief of postoperative pain in adults.

摘要

盐酸丁丙诺啡是一种新型、强效、长效的合成阿片类镇痛剂,具有部分激动-拮抗活性,对重症监护病房的两组患者进行了静脉给药。给药前(对照)及给药后定期采集动脉血进行血气分析,以确定静脉注射丁丙诺啡对重症患者呼吸的影响,每名患者均以自身作为对照。静脉注射0.4毫克丁丙诺啡(第一组 - 10名患者)导致平均呼吸频率显著降低,平均动脉血二氧化碳分压(PaCO2)升高,但心率、动脉血氧分压(PaO2)或碱剩余值未改变。静脉注射0.2毫克丁丙诺啡(第二组 - 10名患者)导致呼吸频率降低和PaCO2升高的程度较小。0.4毫克和0.2毫克丁丙诺啡均有效缓解了疼痛、镇静作用,并减少了烦躁不安,减轻了焦虑。我们的结果表明,静脉注射0.2毫克丁丙诺啡可安全地用于成人术后疼痛的长期缓解。

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