布托啡诺复合氟哌利多用于术中镇痛镇静的临床观察

目的 比较布托啡诺与哌替啶联用氟哌利多用于术中镇痛镇静的临床效果。方法 择期在腰-硬联合麻醉下行下肢骨折手术病人60例，随机均分为布托啡诺组（N组）和哌替啶组（P组）。手术切皮前N组静脉滴注布托啡诺2mg加氟哌利多2．5mg；P组静脉滴注哌替啶50mg加氟哌利多2．5mg。分别记录给药前（T1）、给药后5rain（T2）、30min（T3）以及病人苏醒后（L）的脑电双频指数（BIS）及各时点的HR、MAP、SpO2、RR，并行警觉／镇静评分（OAA／s）。结果 两组各时点HR、MAP、OAA／S、BIS比较差异无统计学意义；P组T1、T2时的SpO2及RR均低于N组（P〈0．05）。结论 布托啡诺联用氟哌利多用于术中镇痛镇静，效果确切，不良反应少。     

小剂量氟哌啶预防腹腔镜胆囊摘除术后恶心呕吐的研究

研究麻醉时用小剂量（1．0mg）氟哌啶对腹腔镜胆囊摘除术（LC）术后恶心呕吐的预防效果及其不良反应。方法：观察78例LC病人，用药组38例，对照组40例，对比术中平均动脉压（MAP）、HR、麻醉恢复室（PACU）评分、术后恶心呕吐发生率等。结果：用药组恶心呕吐发生率（13．2％）明显低于对照组（32．5％）（P＜0．05），MAP、HR、PACU评分在组间无显著差异。结论：小剂量氟哌啶能有效预防LC术后恶心呕吐，对麻醉无明显影响。     

小剂量氟哌利多预防腹腔镜下胆囊切除手术后恶心呕吐的效果评价

目的：评价小剂量氟哌利多预防腹腔镜下胆囊切除手术后恶心呕吐（PONV）的效果。方法：90例ASAⅠ～Ⅱ级择期腹腔镜下胆囊切除患者,随机分成恩丹西酮4mg组（对照组）,氟哌利多10μg/kg组（实验组）,每组45例。观察术后24h内各组患者恶心呕吐的发生率情况。结果：氟哌利多组和恩丹西酮组术后24h内恶心发生率分别是26.7%和31.1%,呕吐发生率是20.0%和15.6%,差异无统计学意义（P〉0.05）。24h内两组均未观察到焦虑、锥体外系反应、Q-T间期延长等副反应的发生。结论：小剂量氟哌利多预防PONV和恩丹西酮一样有效。     

Droperidol suppresses spontaneous electrical activity in neurons cultured from ventral midbrain. Implications for neuroleptanesthesia

Droperidol is used in anesthesia as an antiemetic and as a component in neuroleptanalgesia. Its mechanism of action is thought to involve dopamine receptor blockade in the brain. The electrophysiological consequences associated with this action however, have not been elucidated. In this study we demonstrate a dose-dependent electrophysiological response to droperidol in central nervous system (CNS) neurons that express dopamine receptors that is absent in CNS neurons that do not express dopamine receptors. Primary dissociated cell (PDC) cultures were prepared from embryonal tissue dissected from ventral mesencephalon (VM) and spinal cord (SC). VM neurons were used to investigate the electrophysiological action of droperidol, a dopamine receptor antagonist, since these cultures contain neurons having dopamine receptors on their surface. SC neurons were used as a control as they do not express dopamine receptors. Some dopamine receptors are on dopaminergic neurons and therefore are called autoreceptors, while others are on nondopaminergic neurons, such as GABA producing (GABAergic) neurons. All neurons in both PDC cultures were spontaneously active. The percentage of neurons which spontaneously generated action potentials was reduced in a dose-dependent manner by droperidol (1 nM-10 microM) only in PDC cultures of VM. Exposure to droperidol had no effect on neurons from PDC cultures of SC which lack dopamine receptors. Our results suggest that droperidol modulates the electrophysiological properties of VM neurons with dopamine receptors possibly through facilitation of inhibitory interneurons. The reduced activity of VM neurons might contribute to the antiemetic and/or anesthetic activity of droperidol, since the concentrations of droperidol used in this study are at clinically relevant concentrations.     

The effect of droperidol on mammalian non-myelinated nerve fibres

A study has been made of the effect of droperidol on non-myelinated nerve fibres of the desheathed rabbit vagus. Droperidol did not affect membrane permeability nor the sodium pump activity of the nerve fibres. A specific reduction of sodium influx during the action potential was found in the presence of the drug. Such a specific effect was also observed with local anaesthetics. The potency of droperidol with respect to this action appears to be about 10 times that of lidocaine.     

硬膜外吗啡和氟哌利多超前镇痛的临床研究

目的：比较硬膜外吗啡和氟哌利多超前镇痛与术后镇痛的临床效果和安全性。方法：选择ASAⅠ～Ⅱ级，年龄37～49岁，择期在硬膜外麻醉下行妇科手术的患者30例，随机分为超前镇痛组(Ⅰ组)和术后镇痛组(Ⅱ组)，每组15例。Ⅰ组在术前20min经硬膜外导管一次性注入吗啡2．0mg和氟哌利多1．25mg；Ⅱ组在术毕即硬膜外注入上述等量药物。术后2、4、8、12、24h随访并记录镇痛效果、镇静程度及不良反应，监测血压、心率、呼吸频率、脉搏血氧饱和度；术中记录局麻药用量。结果：超前镇痛组术后8～24h镇痛效果优于术后镇痛组，且局麻药用量减少。结论：硬膜外吗啡和氟哌利多超前镇痛效果优于术后镇痛。     

地塞米松与氟哌利多用于剖宫产患者术后镇痛副作用的疗效比较

目的比较地塞米松和氟哌利多对剖宫产术后硬膜外镇痛的影响。方法180例剖宫产病人,随机分为3组,行硬膜外术后镇痛,每组60例。A组：曲马多600mg、布比卡因100mg、地塞米松10mg;B组：曲马多600mg、布比卡因100mg、氟哌利多5mg;C组：曲马多600mg、布比卡因100mg。每组药液用生理盐水稀释至100ml配成泵液。在关腹时预注泵内液3ml,并教会病人或家属使用PCEA的方法。以视觉模拟评分（VAS）评价镇痛效果,并观察不良反应如恶心、呕吐、瘙瘁、嗜睡,并记录PCEA按压次数。结果三组病人VAS评分、PCEA按压次数无显著差异,但A组低于B、C两组;恶心、呕吐发生率C组高于A、B两组;瘙瘁发生率A组低于B、C组;嗜睡发生率B组高于A、C组。结论地塞米松在剖宫产术后镇痛预防恶心、呕吐、瘙瘁是安全有效的,其副作用比氟哌利多要少,效果更佳。     

氟哌利多预防高血压病人气管插管时心血管反应的临床观察

目的 观察氟哌利多对高血压病人气管插管期间心血管反应的控制效果。方法 对确诊高血压择期全麻手术病人３０例,术前血压均控制在２３．３１／１２．６ｋＰａ以下。随机分为对照组（ｎ＝１５）与氟哌利多组（ｎ＝１５）。氟哌利多组于诱导前１０分钟静注氟哌利多０．２ｍｇ／ｋｇ,对照组注生理盐水。两组均以芬太尼５μｇ／ｋｇ、阿曲库胺０．５ｍｇ／ｋｇ、依托咪酯０．３ｋｇ／ｋｇ静注诱导,１分钟后气管插管。在诱导前、氟哌     

3种药物联合对腹腔镜子宫肌瘤剔除术后自控镇痛患者恶心呕吐的疗效观察

目的探讨采用地塞米松、氟哌利多、昂丹司琼3种药物联合使用在治疗腹腔镜子宫肌瘤剔除术后自控镇痛患者恶心呕吐方面的临床应用价值。方法选取2010年7月～2013年7月南方医科大学附属深圳妇幼保健院收治的150例患有子宫肌瘤需腹腔镜手术的患者，采用双盲的方法将其随机均分为2组（n=75）。对照组常规单独使用昂丹司琼，联合组应用地塞米松、氟哌利多联合昂丹司琼。治疗后2d内比较患者的恶心呕吐情况。结果联合组未发生恶心、呕吐情况，而对照组出现18例，差异有统计学意义（P〈0.05）。结论治疗腹腔镜下子宫肌瘤剔除术后自控镇痛患者恶心呕吐方面，以昂丹司琼为主体，联合使用地塞米松、氟哌利多两种药物具有更加显著的作用，止吐效果更明显，患者更易接受，值得临床推广应用。     

芬太尼联合氟哌利多用于剖宫产术后静脉镇痛效果观察

目的：探讨芬太尼联合氟哌利多用于剖宫产术后患者自控静脉镇痛（Patient-controlled intravenous analgesia,PCIA）的效果及对术后恶心、呕吐（Postoperative nausea and vomit,PONV）不良反应的影响。方法：60例持续硬膜外麻醉下剖宫产术后患者,随机分为观察组和对照组,每组30例,对照组：芬太尼1mg＋生理盐水80ml;观察组：芬太尼1mg＋氟哌利多2.5mg＋生理盐水80ml,分别予自控镇痛泵持续静脉自控泵注2ml/h,观察镇痛、镇静效果及恶心、呕吐不良反应发生率。结果：两组Prince-Henry疼痛评分,在术后1h、2h、4h及8h时间点上,差异无显著性（P〉0.05）。术后16h观察组明显低于对照组,差异有显著性（P〈0.01）。术后24h及48h,观察组低于对照组,差异具有显著性（P〈0.05）;镇静评分,组间比较无显著性差异（P〉0.05）;恶心、呕吐不良反应上,观察组恶心、呕吐发生率明显低于对照组,差异具有统计学意义（P〈0.01）。结论：芬太尼联合氟哌利多用于剖宫产术后自控静脉镇痛效果明显优于单独应用芬太尼,且能有效控制恶心、呕吐等并发症的发生。