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曲唑酮与氟硝西泮用于日间手术术前用药的比较

[Trazodone versus flunitrazepam in premedication in day-care surgery].

作者信息

Bonazzi M, Riva A, Marsicano M, Prampolini F, Speranza R, Andriolli A, Laveneziana D

机构信息

Servizio di Anestesia-Rianimazione e Terapia Intensiva, Ospedale Bassini, Cinisello Balsamo (Milano), Regione Lombardia, USSL 66.

出版信息

Minerva Anestesiol. 1994 Mar;60(3):115-21.

PMID:8090301
Abstract

A prospective single-blind study was conducted to compare flunitrazepam vs trazodone in the premedication of patients undergoing day-case surgery for termination of pregnancy, with particular regard to the degree of preoperative sedation, intraoperative analgesia and postoperative recovery. 86 patients were randomly allocated to receive orally 45 minutes before the surgical procedure either flunitrazepam 2 mg (group F) or trazodone 50 mg (group T). In both groups anaesthesia was achieved by i.v. fentanyl 2.5 micrograms/kg and ketamina 250 micrograms/kg. Patients in group F showed a deeper degree of preoperative sedation. There were no significant differences in intraoperative analgesia and in the immediate arousal time. In the postoperative period, the incidences of emetic symptoms and dizziness were similar in both groups; the incidence of drowsiness was significantly higher in group F at 120 minutes but not at 180 minutes of observation. Psychomotor performance was assessed preoperatively two days before the surgical procedure and 60, 120 and 180 minutes after surgery, using the Toulouse-Pieron test and the reaction time to a luminous stimulus with the aid of a computerized analogic tachystoscope (Neurometer). Trazodone allowed a more rapid recovery of psychomotor performance and it can represent a valid alternative to the use of benzodiazepines in the premedication of day-case surgical patients.

摘要

进行了一项前瞻性单盲研究,以比较氟硝西泮与曲唑酮在妊娠终止日间手术患者术前用药中的效果,特别关注术前镇静程度、术中镇痛和术后恢复情况。86例患者在手术前45分钟随机分配口服2毫克氟硝西泮(F组)或50毫克曲唑酮(T组)。两组均通过静脉注射2.5微克/千克芬太尼和250微克/千克氯胺酮实现麻醉。F组患者术前镇静程度更深。术中镇痛和即刻苏醒时间无显著差异。术后,两组呕吐症状和头晕的发生率相似;F组在观察120分钟时嗜睡发生率显著高于T组,但在180分钟时无差异。在手术前两天术前以及术后60、120和180分钟,使用图卢兹 - 皮埃隆测试以及借助计算机模拟视速仪(神经测量仪)对光刺激的反应时间来评估精神运动表现。曲唑酮能使精神运动表现更快恢复,在日间手术患者术前用药中,它可成为使用苯二氮䓬类药物的有效替代方案。

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