比较remifentanil和芬太尼在接受颅骨切开术的患者幕上的占位性病变。

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家伙J,几何BJ,贝克KZ,波莱尔有限公司Maktabi M, Ostapkovich N,基什内尔J,托德MM, Fogarty-Mack P,杨斯·V, Sokoll医学博士,麦卡利斯特,罗兰C,年轻的王,华纳DS

比较remifentanil和芬太尼在接受颅骨切开术的患者幕上的占位性病变。

麻醉学。1997年3月,86 (3):514 - 24。

PubMed ID

9066316 (在PubMed

]

文摘

背景:Remifentanil盐酸盐是一个超,esterase-metabolized mu-opioid受体激动剂。本研究比较了使用remifentanil或芬太尼在选择性幕上的颅骨切开术占位性病变。方法:六十三名成年人给书面知情同意这种前瞻性,随机,双盲multiple-center试验。麻醉诱导与硫喷妥钠、双、一氧化二氮/氧和芬太尼(n = 32;2 micrograms.kg.-1。最低为1)或remifentanil (n = 31;1 mu.kg - 1. - min - 1)。气管插管后,注入microgram.kg-1率降低到0.03。最低为1(芬太尼)或0.2 microgram.kg-1。最低为1 (remifentanil),然后调整维持麻醉和血流动力学稳定。异氟烷被注入指定加息后才发生。 At the time of the first burr hole, intracranial pressure was measured in a subset of patients. At bone flap replacement either saline (fentanyl group) or remifentanil (approximately 0.2 microgram.kg-1.min-1) were infused until dressing completion. Hemodynamics and time to recovery were monitored for 60 min. Analgesic requirements and nausea and vomiting were observed for 24 h. Neurological examinations were performed before operation and on postoperative days 1 and 7. RESULTS: Induction hemodynamics were similar. Systolic blood pressure was greater in the patients receiving fentanyl after tracheal intubation (fentanyl = 127 +/- 18 mmHg; remifentanil = 113 +/- 18 mmHg; P = 0.004). Intracranial pressure (fentanyl = 14 +/- 13 mmHg; remifentanil = 13 +/- 10 mmHg) and cerebral perfusion pressure (fentanyl = 76 +/- 19 mmHg; remifentanil = 78 +/- 14 mmHg) were similar. Isoflurane use was greater in the patients who received fentanyl. Median time to tracheal extubation was similar (fentanyl = 4 min: range = -1 to 40 min; remifentanil = 5 min: range = 1 to 15 min). Seven patients receiving fentanyl and none receiving remifentanil required naloxone. Postoperative systolic blood pressure was greater (fentanyl = 134 +/- 16 mmHg; remifentanil = 147 +/- 15 mmHg; P = 0.001) and analgesics were required earlier in patients receiving remifentanil. Incidences of nausea and vomiting were similar. CONCLUSIONS: Remifentanil appears to be a reasonable alternative to fentanyl during elective supratentorial craniotomy.

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药物靶点

药物	目标	类	生物	药理作用	行动
Remifentanil	Mu-type阿片受体	蛋白质	人类	是的	受体激动剂	细节