阿片类药物量效关系及其对麻醉药物效应的影响

The dose effect of opiod and interact with other anesthesia drugs

阿片类药物在一定范围内随药量的增减，药物效应也相应增减，当达到一定的血药浓度后，其效应便逐渐出现平台，即随药量的增加，药物效应不增加或增加不明显，此时药物达封顶效应。阿片类药物一旦达到封顶效应，增大剂量不但不增加药物的镇痛效果，反而增加了呼吸抑制、肌肉僵硬、低血压、降心率等副作用的发生率。此文将临床上常用的阿片类药物芬太尼、瑞芬太尼、舒芬太尼和阿片受体结合的特点、阿片类药物量效关系及封顶效应的研究方法以及阿片类药物的副作用进行综述。

Several studies have demonstrated that increases in opioid dose result in a marked alleviation in pain. Further increases in opioid dose provide only a further small alleviation in pain. Thus, a ceiling effect of the opioid is observed. When opoids exhibited a ceiling effect, further increases in opioid dose may result in an increasing side -effect, such as respiratory depression, muscle tetanic, hypotention, tachycardia. A review of the dose - effect and ceiling effect of opoids help clinicians provide a more optimal anesthetic.