Comparison of hemodynamic effects of morphine, butorphanol, buprenorphine and pentazocine on ICU patients.
Comparison of hemodynamic effects of morphine, butorphanol, buprenorphine and pentazocine on ICU patients.
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吗啡、布托啡诺、丁丙诺啡和喷他佐辛对 ICU 患者的血流动力学影响比较。
DOI：
10.11480/btmd.320201
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Y. Mishima
中科院分区：
文献类型：
--
作者：
C. Mitaka;N. Sakanishi;Y. Tsunoda;Y. Mishima
吗啡和麻醉激动剂-拮抗剂已被用于帮助ICU患者适应机械通气。在这项研究中，10毫克的吗啡和等效剂量的合成镇痛剂，2毫克的布托啡诺，0.6毫克的丁丙诺啡或30毫克的喷他佐辛静脉注射给29例需要呼吸机。测定各组大鼠的心率、平均动脉压（MAP）、心脏指数、每搏指数、左室每搏作功指数、平均肺动脉压（MPAP）、肺毛细血管楔压（PCWP）、体循环和肺循环阻力（PVR）等血流动力学指标。4种药物对血流动力学的影响均较轻，除吗啡后PCWP降低、PVR增加，喷他佐辛后MAP和MPAP增加外，其余均无统计学意义。这四种药物的剂量即使在重症患者中也可以安全使用。这些镇痛药的血流动力学效应显示布托啡诺和吗啡给药之间以及丁丙诺啡和喷他佐辛之间的相似性。本研究表明吗啡和布托啡诺对高血压、肺动脉压增高或楔压增高的患者是首选的，喷他佐辛和丁丙诺啡更适合于低血压或低血容量的患者。
Morphine and narcotic agonist-antagonists have been used to assist ICU patients in adapting to mechanical ventilation. In this study, 10 mg of morphine and the equipotent doses of synthetic analgesics, 2 mg of butorphanol, 0.6 mg of buprenorphine or 30 mg of pentazocine were administered intravenously to 29 patients requiring a ventilator. Hemodynamic effects on the heart rate, mean arterial pressure (MAP), cardiac index, stroke index, left ventricular stroke work index, mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure (PCWP) and systemic and pulmonary vascular resistance (PVR) were measured. The hemodynamic effects of the four drugs were mild and not statistically significant except for the reduction in PCWP and the increase in PVR after morphine and the increase in MAP and MPAP after pentazocine administration. These doses of the four drugs could be given safely even in critically ill patients. The hemodynamic effects of these analgesics showed a similarity between the administration of butorphanol and morphine, and between buprenorphine and pentazocine. This study demonstrates that morphine and butorphanol are preferred to the cases with hypertension, increased pulmonary arterial pressure or wedge pressure and that pentazocine and buprenorphine are more suitable for the cases with hypotension or hypovolemia.