Jeffers L A
Mt. Sinai School of Nurse Anesthesia, Cleveland, Ohio, USA.
AANA J. 1996 Dec;64(6):541-4.
Combination drug therapy can effectively treat the problem of obesity. The most commonly used combination is a mix of fenfluramine and phentermine. Fenfluramine inhibits the reuptake of serotonin and acts on the hypothalmic appetite control center, while phentermine acts as an appetite suppressant. These drugs along with diet and exercise effectively help people to lose weight with few side effects. However, there are several anesthetic considerations when providing anesthesia services for patients on the fenfluramine and phentermine regimen. Problems of hypotension on induction, hypoglycemia, hyperthermia, and pulmonary hypertension have been reported in the literature. Recently, dexfenfluramine (Redux) was approved by the U.S. Food and Drug Administration. It is the dextrostereoisomer of fenfluramine and is believed to produce the same weight loss with less side effects. Anesthesia providers must understand the potential risks involved when administering a general anesthetic to these patients.
联合药物疗法可有效治疗肥胖问题。最常用的联合用药是芬氟拉明和苯丙胺的混合剂。芬氟拉明抑制血清素的再摄取并作用于下丘脑食欲控制中枢，而苯丙胺则起食欲抑制剂的作用。这些药物与饮食和运动相结合，能有效帮助人们减肥且副作用很少。然而，在为服用芬氟拉明和苯丙胺疗法的患者提供麻醉服务时，有几个麻醉方面的注意事项。文献中已报道了诱导期低血压、低血糖、高热和肺动脉高压等问题。最近，右芬氟拉明（Redux）已获美国食品药品监督管理局批准。它是芬氟拉明的右旋异构体，据信能产生相同的减肥效果但副作用更少。麻醉提供者必须了解对这些患者实施全身麻醉时所涉及的潜在风险。
