Yee J B, Schafer P G, Crandall A S, Pace N L
Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City 84132, USA.
Anesth Analg. 1994 Aug;79(2):320-3. doi: 10.1213/00000539-199408000-00021.
We compared the use of methohexital (0.5 mg/kg) with alfentanil (20 micrograms/kg) as a drug for limiting movement and pain during the placement of a retrobulbar block (RBB). Thirty patients (ASA class I-III) were randomly assigned to receive either methohexital or alfentanil (15 patients in each group). All but two patients (87%) treated with alfentanil were awake and responsive to command. All of the patients given methohexital were unresponsive at the time of block placement. However, less movement was observed when patients were treated with alfentanil compared to methohexital (P < 0.0002). None of the patients treated with alfentanil complained of pain during placement of the RBB. No difference was detected in the incidence of respiratory depression. However, one patient who received alfentanil had a prolonged period of apnea (approximately 30 s) with a significant decrease in oxygen saturation. The incidence of nausea and vomiting and the time to discharge from the outpatient department were similar in the two groups. The results of this study suggest that alfentanil may be used as a single drug to limit movement during placement of retrobulbar block for ophthalmic surgery.
我们比较了甲己炔巴比妥（0.5毫克/千克）与阿芬太尼（20微克/千克）作为在球后阻滞（RBB）放置期间限制运动和疼痛的药物的效果。30例患者（ASA分级I-III级）被随机分配接受甲己炔巴比妥或阿芬太尼治疗（每组15例患者）。除两名患者（87%）外，所有接受阿芬太尼治疗的患者均清醒且对指令有反应。所有接受甲己炔巴比妥治疗的患者在阻滞放置时均无反应。然而，与甲己炔巴比妥相比，接受阿芬太尼治疗的患者观察到的运动较少（P<0.0002）。接受阿芬太尼治疗的患者在RBB放置期间均未抱怨疼痛。在呼吸抑制的发生率方面未检测到差异。然而，一名接受阿芬太尼治疗的患者出现了较长时间的呼吸暂停（约30秒），血氧饱和度显著下降。两组恶心和呕吐的发生率以及门诊出院时间相似。本研究结果表明，阿芬太尼可作为一种单一药物用于限制眼科手术球后阻滞放置期间的运动。
