- 期刊
Effect of Physostigmine on the Loss of Consciousness Induced by Midazolam, Etomidate and Althesin
Physostigmine對Midazolam, Etomidate及Althesin誘導意識喪失的影響
摘要
The effect of physostigmine, a cholinesterase inhibitor, on the loss of consciousness induced by three different intravenous induction anesthetics, namely midazolam, etomidate and althesin at ED_(50), was studied in three comparable groups of patients. Ten min before induction, the first and second groups received physostigmine 8 μg/kg and 16 μg/kg, respectively, and the third group received 2 ml of saline solution. Physostigmine 16 μg/kg resulted in a significant decrease in the percentage of unconscious patients with midazolam (from 50% to 10%), but it did not modify the incidence with etomidate or althesin. Physostigmine at doses of 8 μg/kg and 16 μg/kg could cause 6.7% and 10% nausea, respectively. Although the mechanism of the drug interaction of physostigmine and midazolam is unclear, physostigmine could be used clinically to reverse post-anesthetic somnolence induced by midazolam.
並列摘要
本實驗探討physostigmine（cholinesterase抑制劑）對三種麻醉誘導劑（midazolam, etomidate, althesin）於ED_(50)劑量下產生意識喪失的影響。在每一種麻醉誘導劑皆有三組病人。在給予ED_(50)麻醉誘導劑前十分鐘，第一組給予physostigmine 8μg/kg，第二組physostigmine 16 ug/kg，第三組給予2ml生理食鹽水。發現physostigmine 16 μg/kg會有效降低midazolam產生意識喪失百分比，但對etomidate及althesin沒有影響。另外physostigmine 8 μg/kg及16 μg/kg會分別造成6.7%及10%病人嘔心。目前不知道physostigmine影響midazolam作用機轉，需要進一步探討。因意識喪失在中樞神經抑制上大於嗜睡，所以臨床上可以用physostigmine對抗midazolam所引起麻醉後的嗜睡。