Patschke D
Prakt Anaesth. 1978 Apr;13(2):127-34.
In 50 Patients (group I) anaesthetized with neuroleptanalgesia and in 20 patients (group II) anaesthetized with moderate doses of fentanyl given to supplement nitrous oxide - halothane anaesthesia the postoperative respiratory depression was antagonized with naloxone. Each patient was carefully titrated with small increments of naloxone (40 microgram) given in 1-2 minute intervals. A reversal of the narcotic induced respiratory depression was taken for granted, when respiratory rate exceeded 12/min, tidal volume and blood gas analysis showed normal values. The results demonstrated a correlation between the need for naloxone and the time interval from the last administration of fentanyl to the completion of the operation and the fentanyl consumption per hour. When the interval was less than 1 hour more than 90% of the patients required postsurgical naloxone for respiratory inadequacy. The mean naloxone dose was 20 to 30% of the fentanyl dose given per hour: 1,2 microgram/kg naloxone reversed 4,9 microgram/kg.h fentanyl (group I) and 0,6 microgram/kg naloxone reversed 2,9 microgram/kg.h fentanyl (group II) respectively. To prevent renarcotization it is recommended to administer naloxone i.m. 30 to 45 min after the last naloxone-injection using the total i.v. dose.
在50例接受神经安定镇痛麻醉的患者（I组）和20例接受中等剂量芬太尼补充氧化亚氮-氟烷麻醉的患者（II组）中，术后呼吸抑制用纳洛酮拮抗。每隔1-2分钟给每位患者小心滴定小剂量递增的纳洛酮（40微克）。当呼吸频率超过12次/分钟、潮气量和血气分析显示正常值时，认为麻醉诱导的呼吸抑制已被逆转。结果表明，纳洛酮的需求与从最后一次给予芬太尼到手术结束的时间间隔以及每小时芬太尼消耗量之间存在相关性。当间隔时间小于1小时时，超过90%的患者因呼吸不足需要术后使用纳洛酮。纳洛酮平均剂量为每小时给予的芬太尼剂量的20%至30%：每千克体重1.2微克纳洛酮分别逆转每千克体重每小时4.9微克芬太尼（I组）和每千克体重0.6微克纳洛酮逆转每千克体重每小时2.9微克芬太尼（II组）。为防止再次麻醉，建议在最后一次静脉注射纳洛酮后30至45分钟肌肉注射纳洛酮，使用静脉注射的总剂量。
