Jones D, Laurence A S, Thornton J A
Anaesthesia. 1983 Jan;38(1):29-34. doi: 10.1111/j.1365-2044.1983.tb10369.x.
A total intravenous anaesthetic technique using etomidate, fentanyl and neuromuscular blocking drugs with artificial ventilation of the lungs has been used in 90 patients undergoing elective general and gynaecological surgery. A two-step schedule was used, based on a pharmacokinetic model for rapidly eliminated, intravenously administered drugs. Etomidate 100 micrograms/kg/minute with fentanyl 1 microgram/kg/minute were given for 10 minutes, followed by a maintenance dose at a rate of one-tenth this amount. Concurrent evaluation of the technique led to variations in the adjuvant drugs used (atropine, droperidol and neuromuscular blocking agent). The basic dose schedule provided adequate surgical anaesthesia for 76% of patients (although dose adjustments were used in the remainder), with recovery times of 10 minutes or less in 57% of patients. No further opiate analgesia was needed in 40% of patients postoperatively. Those patients given atropine intravenously prior to induction had a significantly lower incidence of nausea and vomiting postoperatively.
采用依托咪酯、芬太尼和神经肌肉阻滞药物并进行肺人工通气的全静脉麻醉技术已应用于90例接受择期普通外科和妇科手术的患者。基于快速消除的静脉给药药物的药代动力学模型，采用了两步给药方案。以100微克/千克/分钟的速度给予依托咪酯并以1微克/千克/分钟的速度给予芬太尼，持续10分钟，然后以该剂量的十分之一的速度给予维持剂量。对该技术的同步评估导致了所用辅助药物（阿托品、氟哌利多和神经肌肉阻滞剂）的变化。基本给药方案为76%的患者提供了足够的手术麻醉（尽管其余患者进行了剂量调整），57%的患者恢复时间为10分钟或更短。40%的患者术后无需进一步的阿片类镇痛。诱导前静脉给予阿托品的患者术后恶心和呕吐的发生率显著较低。
