Clarke R S
Can Anaesth Soc J. 1983 Mar;30(2):166-73. doi: 10.1007/BF03009347.
Research on the benzodiazepines has shown that they have certain advantages over the opiates as premedicants. Diazepam, which produces good tranquilization, is well absorbed when given orally though absorption is influenced by other drugs given at the same time. Oral lorazepam leads to more prolonged sedation and amnesia but the final elimination is more rapid. Several new intravenous anaesthetics have been introduced during the last five years but none seems likely to replace thiopental. The theoretical disadvantages of thiopental are offset by its water-solubility, and the use of Cremophor EL in preparations of propanidid, alphaxalone, di-isopropyl phenol and one preparation of diazepam has led to many hypersensitivity reactions. Ketamine is gradually finding its rightful place in anaesthesia but its use is becoming limited to anaesthesia in difficult circumstances. The future concomitant use of other drugs and separation of isomers of ketamine may again broaden its applications. The new water-soluble steroid minaxolone has its own disadvantages, and the water-soluble benzodiazepine midazolam is as unpredictable for induction of anaesthesia as diazepam.
对苯二氮䓬类药物的研究表明，作为术前用药，它们比阿片类药物具有某些优势。地西泮能产生良好的镇静作用，口服时吸收良好，不过吸收会受到同时服用的其他药物的影响。口服劳拉西泮会导致更长时间的镇静和失忆，但最终消除更快。在过去五年中引入了几种新型静脉麻醉剂，但似乎没有一种可能取代硫喷妥钠。硫喷妥钠的理论缺点被其水溶性所抵消，而丙泮尼地、α-羟孕酮、二异丙酚和一种地西泮制剂中使用聚氧乙烯蓖麻油已导致许多过敏反应。氯胺酮正在逐渐在麻醉中找到其应有的位置，但它的使用正局限于困难情况下的麻醉。未来与其他药物联合使用以及氯胺酮异构体的分离可能会再次拓宽其应用范围。新型水溶性类固醇米那索龙有其自身的缺点，而水溶性苯二氮䓬类药物咪达唑仑在诱导麻醉方面与地西泮一样不可预测。
