Okuyama M, Nakamura I
Department of Anesthesiology, Kounan Hospital, Sapporo.
Masui. 1998 Nov;47(11):1315-9.
We evaluated the combination of pentazocine and thiamylal as induction agents for laryngeal mask airway (LMA) insertion and compared this with propofol. Ninety-four patients, ASA grade 1 or 2, were randomly assigned to one of four induction groups as follows; group P: propofol 2.5 mg.kg-1, group p 0.3: pentazocine 0.3 mg.kg-1 followed by thiamylal 5 mg.kg-1, group p 0.6: pentazocine 0.6 mg.kg-1 followed by thiamylal 5 mg.kg-1, and group T: thiamylal 5 mg.kg-1. In group T (n = 5), insertion of LMA was impossible due to inadequate anesthesia. In contrast, good and acceptable conditions for LMA insertion were obtained in 85.2%, 86.7%, and 96.9% of group P, p 0.3, and p 0.6, respectively. Apneic interval, endtidal CO2 and arterial CO2 were significantly greater in pentazocine groups than in propofol group (group P < p 0.3 < p 0.6). Systolic pressure decreased after induction in all groups. Decreases in systolic and diastolic pressure were significantly greater in group P. Heart rate did not show any significant change. We conclude that the induction with the combination of pentazocine and thiamylal provides suitable conditions for LMA insertion with more stable hemodynamics compared with propofol. Doses of 0.3 mg.kg-1 seem to be desirable for LMA insertion.
我们评估了喷他佐辛与硫喷妥钠联合用于喉罩置入诱导剂的效果,并将其与丙泊酚进行比较。94例美国麻醉医师协会(ASA)分级为1或2级的患者被随机分为以下四个诱导组之一:P组:丙泊酚2.5mg/kg;p 0.3组:喷他佐辛0.3mg/kg,随后给予硫喷妥钠5mg/kg;p 0.6组:喷他佐辛0.6mg/kg,随后给予硫喷妥钠5mg/kg;T组:硫喷妥钠5mg/kg。在T组(n = 5)中,由于麻醉不足无法置入喉罩。相比之下,P组、p 0.3组和p 0.6组分别有85.2%、86.7%和96.9%的患者获得了良好且可接受的喉罩置入条件。喷他佐辛组的呼吸暂停时间、呼气末二氧化碳分压和动脉二氧化碳分压显著高于丙泊酚组(P组 < p 0.3组 < p 0.6组)。所有组诱导后收缩压均下降。P组收缩压和舒张压的下降幅度显著更大。心率未显示任何显著变化。我们得出结论,与丙泊酚相比,喷他佐辛与硫喷妥钠联合诱导可为喉罩置入提供合适条件,且血流动力学更稳定。对于喉罩置入,0.3mg/kg的剂量似乎较为理想。