Total intravenous anesthesia combined with epidural eptazocine
Total intravenous anesthesia combined with epidural eptazocine
复制标题
全凭静脉麻醉联合硬膜外依他佐辛
作者：
S. Aida;T. Tomiyama;K. Shimoji
为了减少全静脉麻醉（TIVA）中使用的静脉麻醉剂（氯胺酮、地西泮、氟哌利多和维库溴铵）的剂量，在115例患者中，硬膜外给药一种具有神经刺激作用的阿片类药物依他佐辛与TIVA联合使用。在TIVA加硬膜外依他佐辛下手术顺利;麻醉期间观察到EEG和体感诱发电位显著下降，恢复无延迟。麻醉和手术期间和之后的循环反应和血糖水平稳定，无麻醉后呼吸抑制。另一方面，在46例仅接受TIVA的患者中，观察到麻醉期间和麻醉后的高血压、心动过速和血糖升高：25例（54.3%）患者需要血管抑制剂，18例（39.1%）患者需要氧化亚氮。因此，硬膜外依他佐辛可以使TIVA中使用较低剂量的麻醉成为可能，从而减少与TIVA相关的不良反应，如手术期间的高血压、术中意识、麻醉后呼吸抑制、麻醉恢复延迟和麻醉后的神经体征。这可能是由于硬膜外注射依他唑辛对脊髓的β-刺激作用和它的σ-阻断作用，以及它对大脑缺乏μ-作用。
To reduce the doses of intravenous anesthetics (ketamine, diazepam, droperidol, and vecuronium) used in total intravenous anesthesia (TIVA), epidural administration of a ϰ-stimulating opioid, eptazocine, was combined with TIVA in 115 patients. Surgical procedures were uneventful under TIVA plus epidural eptazocine; significant depression of EEG and somatosensory-evoked potentials during anesthesia were observed without delay in recovery. The circulatory response and blood glucose level during and after anesthesia and surgery were stable, and there was no postanesthetic respiratory depression. On the other hand, in 46 patients given TIVA only, hypertension, tachycardia, and elevated blood glucose during and after anesthesia were observed: in 25 (54.3%) patients, a vasodepressor was required, and in 18 (39.1%) patients, nitrous oxide was needed. Therefore, epidural eptazocine may make it possible to use lower doses of anesthesia in TIVA, thus reducing the adverse effects associated with TIVA such as hypertension during surgery, intraoperative awareness, postanesthetic respiratory depression, delayed recovery from anesthesia, and neurological signs after anesthesia. This may be due to the ϰ-stimulating action of epidural eptazocine on the spinal cord and its σ-blocking action, as well as its lack of μ-action on the brain.
氯胺酮对离体猪气管肌松弛作用的机制。
影响因子：
9.8
作者：
Wilson,LE;Hatch,DJ;Rehder,K
通讯作者：
Rehder,K