Flumazenil拮抗Ketamine, Etomidate或Thiopental麻醉效果之評估

Flumazenil，已知benzodiazepine類藥物之有效拮抗劑。本實驗乃是利用隨機，雙盲之臨床試驗方法。每組二十位病人，在麻醉誘導期分別靜脈施予thiopental 300 mg，etomidate 20mg，ketamine 100 mg或flunitrazepam 2 mg。在催醒過程中，每組中十人靜注給予2 ml之0.2 mg flurnazenil溶液，另十人則給予2ml之生理鹽水所有病人均在注射後於5，15，30，60及120分鐘施行甦醒程度及回憶力之評估。結果發現F組給予flumazenil之病人均在五分鐘內有極佳的甦度及恢復回憶力，T組則分別需十五分鐘及三十分鐘，K組及E組則與施予生理鹽水之十人無大區別。結論為flurnazenil可在五分鐘內拮抗flunitrazepam，並顯示在十五至三十分鐘左右時對thiopental似具有類似效果。表示在flumazenil及thiopental之間或許有一些交叉反應存在。

關鍵字

Flumazenil ； Thiopental ； Etomidate ； Ketamine

並列摘要

The effect of flumazenil, a benzodiazepinc antagonist, was assessed in a random, double-blind clinical study in which each of the four groups of surgical outpatients comprising 20 in each was given cither ketamine 100 mg (K), etomidate 20 mg (E), thiopental 300 mg (T) or flunitrazepam 4 mg (F) for induction of anesthesia. On emergence, patients in each group were randomly given 2cc of cither 2 coded solutions, one of which contained 0.2 mg flumazenil and the other of which was normal saline. Following injection of coded solution, all patients were assessed at 0, 5, 15, 30, 60 and 120 min for wakefulness. All 10 patients of gronp F who received flumazenil were alert and able to recall at 5 min, whereas in gronp T this was noted from 15 to 30 min. Patients of gronp E and K responded alike in a manner as of those who received normal saline placebo with onset of wakefulness at 30 and 60 min respectively. These results confirm that flumazenil antagonizes flunitrazepam (within 5 min) and also indicate that the antagonizing effect occurs 30 min following injection for thiopental, suggestive of some cross-reactivity between these two drugs.

並列關鍵字

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Flumazenil拮抗Ketamine, Etomidate或Thiopental麻醉效果之評估

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