纳美芬拮抗呼吸抑制及增强镇痛作用的研究

目的观察小剂量纳美芬和纳洛酮拮抗阿片类药物呼吸抑制作用以及增强镇痛的效果。方法随机双盲对照研究,择期行胃肠手术患者63例,随机分为对照组、纳美芬组和纳洛酮组各21例。异丙酚和舒芬太尼麻醉诱导及麻醉维持,手术结束5分钟后静脉推注试验药物。记录患者清醒时间和呼吸恢复率、血流动力学变化、视觉模拟评分(Visual Analogue Scule,VAS评分)等。结果纳美芬组的拔管时间短于纳洛酮组,而两组睁眼时间、恢复指令时间差异无统计学意义。纳美芬组的呼吸恢复率优于另两组。三组患者VAS评分及术后镇痛药需求量差异无统计学意义,但纳洛酮组患者血压明显高于纳美芬组。结论纳美芬0.5μg/kg和纳洛酮2μg/kg可获得满意的拮抗阿片类药物术后呼吸抑制效果,纳美芬对血流动力学影响较小,未观察到该剂量的纳美芬加强镇痛的作用。

Nalmefene on antagonizing respiratory depression and enhancing the analgesic effect

Objective The aims of this study was to compare the effect of low dose Nalmefene with Naloxone on antagonizing the respiratory depression caused by opioids and to evaluate their analgesic effects.Methods Sixty-three patients undergoing gastrointestinal surgery were enrolled into this double blinded and randomized control trial and were divided into 3 groups.They all received anesthesia induction and maintenance of anesthesia.Interventions were given intravenously at 5 minutes after the end of surgery and an...