氟马西尼与贝美格对七氟醚麻醉后催醒效果的比较  

Analeptic effects of flumazenil or bemegride in patients emerging from sevoflurane inhalation

作　　者：漆升 

机构地区：[1]浙江省建德市第一人民医院麻醉科,建德311600

出　　处：《临床医学》2008年第4期16-18,共3页Clinical Medicine

摘　　要：目的比较氟马西尼与贝美格对七氟醚麻醉后催醒效果。方法60例择期行腹腔镜胆囊切除手术患者随机分为三组,每组20例。手术结束后,静脉分别给予观察I组氟马西尼0.008 mg/kg、观察I I组贝美格1 mg/kg,给予对照组等容量的生理盐水。分别记录三组患者入手术室后、麻醉前、用氟马西尼、贝美格及安慰剂后1、3、5 min的心率(HR)、平均动脉血压(MAP)、脉搏血氧饱和度(SpO2)。记录用药后1 min患者的清醒级,恢复四级清醒的时间及用药后的不良反应。结果氟马西尼组用药后1 min清醒级明显高于对照组、术后4级清醒时间亦明显短于对照组,这表明氟马西尼有一定的催醒效果,但其用药后1 min清醒级明显低于贝美格组,其术后4级清醒时间亦明显长于贝美格组,可见其催醒作用不如贝美格明显。然而用药后氟马西尼组MAP、HR及躁动、恶心、呕吐发生率均低于贝美格组。结论氟马西尼对七氟醚麻醉后有一定的催醒效果,其作用不如贝美格明显,但其不良反应亦明显低于贝美格,对患有心血管性疾病及神经、精神类疾病者较贝美格安全。Objective To investigate the analeptic effects of flumazenil or bemegride in patients emerging from sevoflurane inhaled anesthesia. Methods Sixty patients, undergoing elective laparoseopic eholecysteetomy under sevoflurane inhalation, were randomly divided into three groups, with 20 cases each. At the end of operation, group Ⅰ received flumazenil （0. 008 mg/kg） iv, group Ⅱ received Bemegride （1 mg/kg）iv and control group received normal saline iv. HR, MAP, SpO2 and the levels of alertness score were observed during different periods. Results In flumazenil group , the level of alertness score after 1 rain of iv was higher than in control group , but lower than in bemegride group. The time to level 4 of alertness score in flumazenil group was shorter than in Control group , but it was longer than in bemegride group . It showed that flumazenil had some awaking effects , but it was not as good as bemegride. The adverse drag reactions in bemegride group were more than in flumazeil group. Conclusion Flumazenil has some awaking effects in patients emerging from Sevoflurane inhalation, but it is not as good as bemegride. The adverse effects of drags in flumazenil group are less than in bemegride group. And Flumazenil is safer than bemegride for patients with cardiovascular disease or mental disease.

关 键 词：氟马西尼 贝美格 七氟醚 吸入麻醉 

分 类 号：R614[医药卫生—麻醉学]