地西泮或吗啡预处理对依托那龙诱导剂量的影响。

Influence of premedication with diazepam or morphine on the induction dose of eltanolone.

作者信息

Czuchwicki A, Plummer J L, Love D R, Owen H, Ilsley A H

机构信息

Department of Anaesthesia, Flinders Medical Centre, and the Flinders University of South Australia, Bedford Park.

出版信息

Acta Anaesthesiol Scand. 1998 May;42(5):527-31. doi: 10.1111/j.1399-6576.1998.tb05161.x.

DOI:10.1111/j.1399-6576.1998.tb05161.x

PMID:9605367

Abstract

BACKGROUND

This study examined the influence of premedication with morphine or diazepam on the dose of eltanolone, a steroidal intravenous anaesthetic agent, required to induce anaesthesia.

METHODS

Two hundred and sixteen patients, aged 18 to 65 years, were randomly assigned to receive premedication with diazepam 10 mg orally, morphine 10 mg intramuscularly, or placebo. The double-dummy technique was used to maintain blinding. Eltanolone 0.16-0.75 mg x kg(-1) was given intravenously over 20 s. At the commencement of injection patients were instructed to begin counting; if the patient ceased counting within 120 s and failed to respond to commands to continue, anaesthesia was considered to have been induced. The dose required to anaesthetise 50% of patients (ED50) was determined by logistic regression.

RESULTS

The ED50 (95% confidence interval) of eltanolone in patients who received placebo premedication was 0.31 (0.27-0.34) mg x kg(-1). It was reduced slightly and nonsignificantly by premedication with diazepam, to 0.27 (0.24-0.30) mg x kg(-1), or morphine, to 0.26 (0.23-0.29) mg x kg(-1). Involuntary movement occurred in 65% of placebo premedicated patients. Its incidence was not significantly reduced by diazepam (57%), but was significantly (P<0.001) reduced by morphine (37%). Morphine premedication was, however, associated with a significant (P<0.01) increase in the incidence of apnoea (21%) compared to placebo premedicated patients (4%).

CONCLUSION

Premedication with diazepam or morphine had little influence on the dose of eltanolone required to induce anaesthesia.

摘要

背景

本研究考察了吗啡或地西泮预处理对诱导麻醉所需的甾体类静脉麻醉药依托那龙剂量的影响。

方法

216例年龄在18至65岁的患者被随机分配接受口服10 mg地西泮、肌内注射10 mg吗啡或安慰剂进行预处理。采用双盲技术以维持盲法。依托那龙0.16 - 0.75 mg·kg⁻¹在20秒内静脉注射。在注射开始时指示患者开始计数；如果患者在120秒内停止计数且对继续计数的指令无反应，则认为麻醉已诱导成功。通过逻辑回归确定使50%患者麻醉所需的剂量（ED50）。

结果

接受安慰剂预处理的患者中依托那龙的ED50（95%置信区间）为0.31（0.27 - 0.34）mg·kg⁻¹。用地西泮预处理后略有降低但无显著差异，降至0.27（0.24 - 0.30）mg·kg⁻¹，用吗啡预处理后降至0.26（0.23 - 0.29）mg·kg⁻¹。接受安慰剂预处理的患者中有65%出现不自主运动。地西泮预处理后其发生率未显著降低（57%），但吗啡预处理后显著降低（P < 0.001）（37%）。然而，与接受安慰剂预处理的患者（4%）相比，吗啡预处理使呼吸暂停的发生率显著增加（P < 0.01）（21%）。