Silver H, Codesmith A O
Ann Plast Surg. 1980 Dec;5(6):483-5. doi: 10.1097/00000637-198012000-00013.
An approach to outpatient anesthesia using drugs that have reversible or very short-acting effects is described, along with a method of monitoring patients using pulse rate to assess tranquility. Preoperatively, the patient is given 1 mg of lorazepam the evening before surgery and sublingual lorazepam 1 mg combined with hydroxyzine 50 mg intramuscularly one hour before surgery. Before infiltration of local anesthesia, intravenous diazepam in 2.5 mg increments is given if needed, followed by a mixture of meperidine and pentazocine intravenously in exactly a 10:1 ratio. If hypnosis is needed, methohexital can be administered using a 0.2% drip by infusion pump. If respiratory depression is seen, intravenous naloxone, 0.2 to 0.4 mg, can be given to reverse any residual effects of meperidine and pentazocine, or, if large doses of intravenous diazepam have been used in a very agitated patient, one can administer physostigmine 1 to 2 mg.
本文描述了一种使用具有可逆或超短效作用药物的门诊麻醉方法，以及一种通过脉搏率监测患者以评估镇静程度的方法。术前，患者在手术前一晚服用1毫克劳拉西泮，术前1小时舌下含服1毫克劳拉西泮并肌肉注射50毫克羟嗪。在局部麻醉浸润前，必要时静脉注射地西泮，每次增量2.5毫克，随后静脉注射哌替啶和喷他佐辛的混合液，比例为10:1。如需催眠，可用输液泵以0.2%的滴注速度给予甲己炔巴比妥。如出现呼吸抑制，可静脉注射0.2至0.4毫克纳洛酮以逆转哌替啶和喷他佐辛的任何残留作用，或者，如果在极度躁动的患者中使用了大剂量静脉注射地西泮，可给予1至2毫克毒扁豆碱。
