Co-induction of anaesthesia: the rationale.
Co-induction of anaesthesia: the rationale.
复制标题
麻醉的共同诱导：基本原理。
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
S. Allen
中科院分区：
文献类型：
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作者：
R. Amrein;W. Hetzel;S. Allen
两种或两种以上不同药物的联合治疗，目的是达到相同的治疗目标，长期以来受到严重批评。然而，它今天被接受，特别是当可以显示出优于单药治疗的优势时。对于麻醉诱导或重症监护室中的长期镇静，联合治疗可提供改善的效果特征、期望与不良反应的更平衡比例、改善的效果时程、更简单的治疗要求或更低的成本。咪达唑仑和丙泊酚已被研究为这两种适应症的潜在合作伙伴。比较了它们的作用机制、药代动力学特性、药理作用、在受体位点相互作用的方式、药物制剂的差异、副作用概况和经济考虑。动物实验和临床药理学研究表明，咪达唑仑和丙泊酚与其他中枢活性药物具有协同作用。结论：咪唑安定与丙泊酚的协同作用可改善不良反应与预期效果的关系。与单药治疗相比，联合诱导麻醉和长期镇静联合给药可改善治疗情况。这些改进是在更合适的效果特征、更有利的期望效果与副作用的比率、效果的时间过程的优化和降低的成本方面。
Combination therapy with two or more different drugs, with the intention of reaching the same therapeutic goal, was heavily criticized for a long time. However, it is accepted today, especially when advantages over monotherapy can be shown. For the induction of anaesthesia or for long-term sedation in the intensive care unit, combination therapy may offer an improved effect profile, a more balanced ratio of desired versus adverse effects, an improved time-course of effect, simpler treatment requirements or lower costs. Midazolam and propofol have been investigated as potential partners for those two indications. The mechanism of action, pharmacokinetic properties, pharmacological effect, the way in which they interact at the receptor site, the differences in pharmaceutical formulations, the side-effect profiles and economic considerations were compared. Animal experiments and clinical pharmacology studies have shown that midazolam and propofol have synergy with other centrally active drugs. It could be expected that the relationship between desired effects and adverse effects could be improved by skilful use of the synergism between midazolam and propofol. Co-induction of anaesthesia and co-administration in long-term sedation can offer improvements in therapeutic situations compared with monotherapy. These improvements are in terms of a more suitable effect profile, a more favourable ratio of desirable effects to side-effects, optimization of the time-course of effects and reduced costs.