抄録
Nineteen upper abdominal surgery patients were anesthetized with one of the two different modified neuroleptanesthesia (NLA), employing buprenorphine or pentazocine, and their comparative effects on cardiovascular parameters and postoperative analgesia were analysed.
(1) Cardiovascular effects of buprenorphine 6μg/kg (nine patients) and pentazocine 1mg/kg (ten patients)
Swan-Ganz catheter were placed to measure pulmonary artery pressure (PAP), pulmonary capillary wedge pressure and cardiac output at 0, 5, 10, and 15 minutes after the intravenous administration under spontaneous air breathing. Significant changes were observed in PAP, among other parameters. Pentazocine significantly elevated PAP, beyond the normal range. Buprenorphine elevated the PAP, within normal range. The elevated PAP returned to the normal range as soon as the trachea was intubated and controlled respiration was started.
(2) Cardiovascular changes during the modified NLA.
Abrupt and significant elevation of the arterial blood pressure was seen in almost every patient of pentazocine NLA as soon as the peritoneum was opened. Trimetaphan was effective to control the systolic arterial pressure within 170 to 120mmHg, but there were no signifficant differences in the required doses of agent among the two different NLA.
(3) Postoperative analgesia.
Buprenorphine gave a prolonged postoperative analgesia for 72 hours, except two patients to whom rectal indomethacine (50mg) was given twice. Analgesics were given 12 times to seven patient during the 72 postoperative hours after the modified NLA with pentazocine.
