芬太尼／哌替啶致Oddi括约肌痉挛的探讨

２００例择期胆囊切除＋术中胆道造影患者分二组；芬太尼１７ｕｇ／ｋｇ静注（Ｆ组，ｎ＝１００）、哌替啶１ｍｇ／ｋｇ静注。评价两种麻醉性镇痛药致Ｏｄｄｉ括约肌痉挛的发生率，结果：８例病人造影剂不能通过Ｏｄｄｉ括约肌、十二指肠不显影，胆总管下端显示“鸟嘴样”或“假结石”影像，后者３例病人胆总管探查阴性，静注纳络酮０．４ｍｇ后，全部病例造影剂顺利进入十二指肠。结论：硬膜外麻醉辅用小剂量芬太尼／哌替啶时Ｏｄｄ

Study of fentanyl/Pethidine induced Spasm of the sphincter of oddi

Two groups of 100 patients were studied prospectively to assess the incidenceof spasm of the sphincter of Oddi (ISSO ) during elective cholecystectomy andcholangiography under epidural anesthesia with fentanyl/pethidine-supplemented analgesia.We Conclude that the ISSO using fentanyl/pethidine-supplemented is low(4%) , but failure to apprecate it may lead to needless surgical exploration of the CBD . Naloxone may effectively identify narcotic-induced spincter spasm and stone impaction.