Mehta D, Bradley E L, Kissin I
Department of Anesthesiology, University of Alabama School of Medicine, Birmingham.
Anesth Analg. 1993 Oct;77(4):784-7. doi: 10.1213/00000539-199310000-00023.
We compared the effect of metoclopramide (MCA) with droperidol (DPD) on thiopental hypnotic requirements in 96 unpremedicated female patients. The study was randomized, double-blind, and placebo-controlled. The response to the verbal command was used as an end-point of anesthesia. Two methods of determination of thiopental hypnotic requirements were used: titration (infusion of thiopental at a rate of 0.5 mg.kg-1 x min-1) until the end-point was reached and construction of the dose-response curve based on bolus injections of predetermined doses of thiopental (with the use of probit analysis). The ED50 value of thiopental determined by probit analysis was reduced after the 0.2 mg/kg MCA administration by 44% (P < 0.0001). The thiopental hypnotic requirements obtained with the titration method were as follows: 5.3 +/- 0.3 mg/kg in control, 4.5 +/- 0.2 mg/kg (delta 14%, P < 0.03) with 0.1 mg/kg MCA, 3.2 +/- 0.2 mg/kg (delta 39%, P < 0.0001) with 0.2 mg/kg MCA, and 2.9 +/- 0.2 mg/kg (delta 45%, P < 0.0001) with 0.4 mg/kg MCA. DPD decreased thiopental hypnotic requirements almost to the same degree as MCA, with the ceiling effect observed at doses of 0.01 and 0.02 mg/kg (delta 44%, P < 0.0001). The results indicate that MCA causes a profound decrease in thiopental hypnotic requirements. The similarity between the thiopental sparing effects of MCA and DPD suggests that the blockade of D2 receptors is the main mechanism underlying this effect.
我们比较了甲氧氯普胺（MCA）和氟哌利多（DPD）对96例未用术前药的女性患者硫喷妥钠催眠需求量的影响。该研究为随机、双盲且安慰剂对照试验。对言语指令的反应被用作麻醉终点。采用了两种测定硫喷妥钠催眠需求量的方法：滴定法（以0.5mg·kg⁻¹·min⁻¹的速率输注硫喷妥钠）直至达到终点，以及基于预先确定剂量的硫喷妥钠推注构建剂量 - 反应曲线（使用概率分析）。通过概率分析确定，给予0.2mg/kg MCA后，硫喷妥钠的ED50值降低了44%（P < 0.0001）。滴定法得到的硫喷妥钠催眠需求量如下：对照组为5.3±0.3mg/kg，给予0.1mg/kg MCA时为4.5±0.2mg/kg（降低14%，P < 0.03），给予0.2mg/kg MCA时为3.2±0.2mg/kg（降低39%，P < 0.0001），给予0.4mg/kg MCA时为2.9±0.2mg/kg（降低45%，P < 0.0001）。DPD降低硫喷妥钠催眠需求量的程度与MCA几乎相同，在0.01和0.02mg/kg剂量时出现封顶效应（降低44%，P < 0.0001）。结果表明，MCA可使硫喷妥钠催眠需求量大幅降低。MCA和DPD对硫喷妥钠的节省效应相似，提示D2受体阻滞是该效应的主要潜在机制。
