Spaulding B C, Choi S D, Gross J B, Apfelbaum J L, Broderson H
Anesthesiology. 1984 Nov;61(5):551-4. doi: 10.1097/00000542-198411000-00013.
The authors conducted a double-blind crossover study to determine the effects of physostigmine salicylate on hyperoxic ventilatory response to carbon dioxide (VE RCO2) and on awareness in healthy subjects previously sedated with diazepam. Diazepam 0.4 mg/kg iv decreased the slope of VE RCO2 from 2.41 +/- 0.19 to 1.30 +/- 0.15 1 . min-1 . mmHg-1 (mean +/- SEM, P less than 0.001). Subsequent injection of physostigmine 2.0 mg iv was associated with a 0.20 +/- 0.28 1 . min-1 . mmHg-1 decrease in slope; this was significantly different from the 0.56 +/- 0.22 1 . min-1 . mmHg-1 increase in slope associated with saline placebo (P less than 0.05). Level of consciousness, on the other hand, increased more after physostigmine than after saline (P less than 0.01). The authors conclude that despite an apparent increase in awareness resulting from physostigmine administration, the accompanying decrease in ventilatory drive may contraindicate its use in patients who previously have received diazepam.
作者进行了一项双盲交叉研究，以确定水杨酸毒扁豆碱对高氧条件下二氧化碳通气反应（VE RCO2）以及对先前使用地西泮镇静的健康受试者意识的影响。静脉注射0.4mg/kg地西泮可使VE RCO2的斜率从2.41±0.19降至1.30±0.15 1.min-1.mmHg-1（平均值±标准误，P＜0.001）。随后静脉注射2.0mg毒扁豆碱，斜率降低了0.20±0.28 1.min-1.mmHg-1；这与盐水安慰剂使斜率增加0.56±0.22 1.min-1.mmHg-1有显著差异（P＜0.05）。另一方面，与盐水相比，毒扁豆碱注射后意识水平的提高更为明显（P＜0.01）。作者得出结论，尽管使用毒扁豆碱后意识明显提高，但随之而来的通气驱动力下降可能表明先前接受过地西泮治疗的患者不宜使用该药。
