腺苷對全憑靜脈麻醉中丙泊酚用量的影響_《華西醫學》

作者：

覃文明 , 王焱

巴中市中心醫院麻醉科（四川巴中，636000）;

關鍵詞：

腺苷丙泊酚全憑靜脈麻醉劑量

DOI：

10.7507/1002-0179.20130022

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目的　探討全憑靜脈麻醉中腺苷對丙泊酚用量的影響。方法　2011年1月－12月期間59例行擇期手術的患者全憑靜脈麻醉，隨機分為腺苷靜脈持續輸注組（A組）和對照組（B組），A組患者麻醉誘導后持續輸注腺苷70 μg/（kg·min），直至術畢。B組麻醉后按常規處理。比較兩組患者麻醉時間、蘇醒時間、瑞芬太尼用量，麻醉過程中平均動脈壓（MAP）、心率，以及麻醉過程中丙泊酚的用量。同時記錄使用腺苷過程中的不良反應。結果　兩組患者麻醉時間、蘇醒時間、瑞芬太尼用量比較均無明顯差異，無統計學意義（P＞0.05）。兩組患者麻醉過程中MAP、心率比較亦無明顯差異，無統計學意義（P＞0.05）。兩組患者麻醉過程中丙泊酚平均用量比較，A組明顯低于C組，差異有統計學意義（P＜0.05），且不良反應發生率低。結論　腺苷能明顯降低全憑靜脈麻醉中丙泊酚的使用劑量。

引用本文： 覃文明,王焱. 腺苷對全憑靜脈麻醉中丙泊酚用量的影響. 華西醫學, 2013, 28(1): 80-82. doi: 10.7507/1002-0179.20130022 復制

1.	Sawynok J, Zarrindast MR, Reid AR, et al. Adenosine a3 receptor activation produces nociceptive behaviour and edema by release of histamine and 5-hydroxytryptamine[J]. Eur J Pharmacol, 1997, 333(1): 1-7.
2.	Donnelly-Roberts D, Mcgaraughty S, Shieh CC, et al. Painful purinergic receptors[J]. J Pharmacol Exp Ther, 2008, 324(2): 409-415.
3.	Segerdahl M, Ekblom A, Sandelin K, et al. Peroperative adenosine infusion reduces the requirements for isoflurane and postoperative analgesics[J]. Anesth Analg, 1995, 80(6): 1145-1149.
4.	Seitz PA, ter Riet M, Rush W, et al. Adenosine decreases the minimum alveolar concentration of halothane in dogs[J]. Anesthesiology, 1990, 73(5): 990-994.
5.	Mantz J, Lecharny JB, Laudenbach V, et al. Anesthetics affect the uptake but not the depolarization-evoked release of GABA in rat striatal synaptosomes[J]. Anesthesiology, 1995, 82(2): 502-511.
6.	Yue L, Xie A, Bruzik KS, et al. Potentiating action of propofol at GABAA receptors of retinal bipolar cells[J]. Invest Ophthalmol Vis Sci, 2011, 52(5): 2497-2509.
7.	Fischer MJ, Leffler A, Niedermirtl F, et al. The general anesthetic propofol excites nociceptors by activating TRPV1 and TRPA1 rather than GABAA receptors[J]. J Biol Chem, 2010, 285(45): 34781-34792.
8.	Strieker M, Nolan EM, Walsh CT, et al. Stereospecific synthesis of threo-and erythro-β-Hydroxyglutamic acid during kutzneride biosynthesis[J]. J Am Chem Soc, 2009, 131(37): 13523-13530.
9.	Ralevic V, Burnstock G. Receptors for purines and pyrimidines[J]. Pharmacol Rev, 1998, 50(3): 413-492.
10.	王任燁, 狄楓, 徐英, 等. 腺苷及其受體在神經系統中的生物學作用[J]. 國外醫學·藥學分冊, 2006, 33(4): 279-282.
11.	Deng Q, Terunuma M, Fellin T, et al. Astrocytic activation of A1 receptors regulates the surface expression of NMDA receptors through a Src kinase dependent pathway[J]. Glia, 2011, 59(7): 1084-1093.
12.	曲衛敏, 孫宇, 許奇, 等. 腺苷和睡眠覺醒調節[J]. 生物物理學報, 2011, 27(1): 5-17.
13.	趙靜, 米文麗. 毛應啟梁.腺苷及其受體參與外周痛覺信息調控的機制[J]. 國際病理科學與臨床雜志, 2011, 31(4): 301-303.
14.	Zárate E, Sá Rêgo MM, White PF, et al. Comparison of adenosine and remifentanil infusions as adjuvants to desflurane anesthesia[J]. Anesthesiology, 1999, 90(4): 956-963.
15.	Fukunaga AF, Alexander GE, Stark CW. Characterization of the analgesic actions of adenosine: comparison of adenosine and remifentanil infusions in patients undergoing major surgical procedures[J]. Pain, 2003, 101(1-2): 129-138.

1. 　Sawynok J, Zarrindast MR, Reid AR, et al. Adenosine a3 receptor activation produces nociceptive behaviour and edema by release of histamine and 5-hydroxytryptamine[J]. Eur J Pharmacol, 1997, 333(1): 1-7.
2. 　Donnelly-Roberts D, Mcgaraughty S, Shieh CC, et al. Painful purinergic receptors[J]. J Pharmacol Exp Ther, 2008, 324(2): 409-415.
3. 　Segerdahl M, Ekblom A, Sandelin K, et al. Peroperative adenosine infusion reduces the requirements for isoflurane and postoperative analgesics[J]. Anesth Analg, 1995, 80(6): 1145-1149.
4. 　Seitz PA, ter Riet M, Rush W, et al. Adenosine decreases the minimum alveolar concentration of halothane in dogs[J]. Anesthesiology, 1990, 73(5): 990-994.
5. 　Mantz J, Lecharny JB, Laudenbach V, et al. Anesthetics affect the uptake but not the depolarization-evoked release of GABA in rat striatal synaptosomes[J]. Anesthesiology, 1995, 82(2): 502-511.
6. 　Yue L, Xie A, Bruzik KS, et al. Potentiating action of propofol at GABAA receptors of retinal bipolar cells[J]. Invest Ophthalmol Vis Sci, 2011, 52(5): 2497-2509.
7. 　Fischer MJ, Leffler A, Niedermirtl F, et al. The general anesthetic propofol excites nociceptors by activating TRPV1 and TRPA1 rather than GABAA receptors[J]. J Biol Chem, 2010, 285(45): 34781-34792.
8. 　Strieker M, Nolan EM, Walsh CT, et al. Stereospecific synthesis of threo-and erythro-β-Hydroxyglutamic acid during kutzneride biosynthesis[J]. J Am Chem Soc, 2009, 131(37): 13523-13530.
9. 　Ralevic V, Burnstock G. Receptors for purines and pyrimidines[J]. Pharmacol Rev, 1998, 50(3): 413-492.
10. 　王任燁, 狄楓, 徐英, 等. 腺苷及其受體在神經系統中的生物學作用[J]. 國外醫學·藥學分冊, 2006, 33(4): 279-282.
11. 　Deng Q, Terunuma M, Fellin T, et al. Astrocytic activation of A1 receptors regulates the surface expression of NMDA receptors through a Src kinase dependent pathway[J]. Glia, 2011, 59(7): 1084-1093.
12. 　曲衛敏, 孫宇, 許奇, 等. 腺苷和睡眠覺醒調節[J]. 生物物理學報, 2011, 27(1): 5-17.
13. 　趙靜, 米文麗. 毛應啟梁.腺苷及其受體參與外周痛覺信息調控的機制[J]. 國際病理科學與臨床雜志, 2011, 31(4): 301-303.
14. 　Zárate E, Sá Rêgo MM, White PF, et al. Comparison of adenosine and remifentanil infusions as adjuvants to desflurane anesthesia[J]. Anesthesiology, 1999, 90(4): 956-963.
15. 　Fukunaga AF, Alexander GE, Stark CW. Characterization of the analgesic actions of adenosine: comparison of adenosine and remifentanil infusions in patients undergoing major surgical procedures[J]. Pain, 2003, 101(1-2): 129-138.

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《華西醫學》

腺苷對全憑靜脈麻醉中丙泊酚用量的影響

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