N2O+ O2+ハロタン麻酔中のフェンタニルとナロキソンの拮抗作用

フェンタニル誘発性呼吸抑制に対するナロキソンの拮抗効果を調査するために、55人の患者（さまざまな研究および対照群にランダムに分割され、亜酸化酸化酸素 - ハロタン麻酔中に研究が研究されました。末端CO2は、15枚のマイクログラム/kgがフェンタニルに拮抗するために必要でした他の麻酔からの回復が0から10に記録されているように、ナロキソンによって逆転しました（新生児のAPGARスコアの修正を使用）。しかし、これらの患者では術後疼痛スコアが高く、吐き気と嘔吐の発生率が高いことが記録されました。この研究は、総拮抗作用の推定に対するフェタニルとナロキソンの用量関係を示しています。ただし、麻酔の終了時の部分拮抗作用にナロキソンを使用することは、これらの発見に基づくことはできません。

To investigate the antagonistic effect of naloxone on fentanyl-induced respiratory depression, 55 patients (randomly divided into various study and control groups were studied during nitrous-oxide-oxygen-halothane anaesthesia. Respiratory depression after 0.1 mg of fentanyl was totally reversed by 10 microgram/kg of naloxone, measured as 100% restoration of spontaneous respiration, normal minute volume and end-tidal CO2, while 15 microgram/kg of naloxone was needed to antagonize 0.2 mg of fentanyl. The respective control groups remained apnoeic. If no fentanyl had previously been administered, there was no difference in the respiratory behaviour of naloxone-treated and control patients, which indicates that no unspecific analeptic effect of naloxone could be demonstrated. The circulatory changes after fentanyl were nearly reversed by naloxone, as has been found earlier with other narcotics. Recovery from anaesthesia was scored from 0 to 10 (using a modification of Apgar scores for newborns), and somewhat higher mean scores were obtained with the naloxone-treated patients than with their controls. However, higher postoperative pain scores were recorded in these patients as well as a higher incidence of nausea and vomiting. The study demonstrates the dose-relationships of fetanyl and naloxone for estimation of total antagonism; however, the use of naloxone for partial antagonism at the termination of anaesthesia cannot be based on these findings.