Barbiturate anesthetics are intravenous drugs used to induce rapid anesthesia, they are then maintained with an inhaled drug. Methohexital (Brevital) is the only drug remaining in this class
巴比妥类麻醉剂为IV药，用于诱导快速麻醉，然后通过吸入药物维持麻醉。美索比妥（美索比妥钠）为该类唯一保留的药。
Therapeutic Actions and Indications 治疗作用与适应症
Methohexital lacks analgesic properties, and the patient may require postoperative analgesics.
美索比妥缺乏镇痛特性，患者可能需要术后镇痛药。
Pharmacokinetics 药代动力学
Methohexital has a rapid onset of action and a recovery period that is usually 3 to 4 minutes. This drug is lipophilic. It is dissolved and rapidly absorbed through the lipid blood–brain barrier and diffuses into the brain very rapidly.
美索比妥作用起效快，恢复期通常3 – 4分钟。该药为亲脂性。溶解、吸收快，穿透脂血脑屏障，迅速弥散进入大脑。
Contraindications and Cautions 禁忌和注意事项
Methohexital cannot come in contact with silicone (rubber stoppers and disposable syringes often contain silicone) because it will cause an immediate breakdown of the silicone. As a result, it poses special problems, and special precautions must be taken. This drug should not be used until the anesthesiologist and staff are ready and equipped for intubation and respiratory support because of the rapid onset and because these drugs can cause respiratory depression and apnea. This drug should not be used during pregnancy or lactation unless the benefit clearly outweighs the potential risk to the fetus or neonate because of the CNS depressive effects of these drugs.
The adverse effects associated with these drugs are related to the suppression of the CNS with decreased pulse, hypotension, suppressed respirations, and decreased GI activity. Nausea and vomiting after recovery are common.
与这些药物相关的不良效应都与CNS抑制伴脉搏下降、低血压、呼吸抑制和GI活动减少有关。恢复后恶心和呕吐普遍。
Drug–Drug Interactions 药药相互作用
Caution must be used when these drugs are used with any other CNS suppressants. Barbiturates can cause decreased effectiveness of theophylline, oral anticoagulants, betablockers, corticosteroids, hormonal contraceptives, phenylbutazones, metronidazole, quinidine, and carbamazepine. Combinations of barbiturate anesthetics and narcotics may produce apnea more commonly than occurs with other analgesics.
barbiturate – n. 巴比妥酸盐
barbiturate anesthetics – 巴比妥类麻醉药
induce – v. 诱导，引诱
inhaled – a. 吸入的
methohexital – n. 美索比妥 Brevital – n. 美索比妥钠
onset – n. 起始，发动
lipophilic – a. 亲脂的
silicone – n. 硅酮
rubber stopper – 橡皮塞子
disposable – a. 一次性的，用后即弃的 apnea – n. 呼吸暂停
theophylline – n. 茶碱
phenylbutazone – n. 保泰松
metronidazole – n. 甲硝唑
quinidine – n. 奎尼丁
carbamazepine – n. 卡马西平
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★Video ★
Barbiturates
★Test ★
1. The nurse receives the client in the postanesthesia care unit (PACU) following a procedure requiring general anesthesia. The most important assessment made by the nurse relates to the client’s:
A. Level of consciousness.
B. Pain.
C. Vital signs.
D. Respiratory status. 2. All narcotics, regardless of their origin, reduce pain by:
A. Stimulating opiate receptors
B. Promoting the release of excitatory transmitters
C. Releasing large quantities of endorphin
D. Blocking the mu receptors
奥医教育ISPN / NCLEX-RN “在线自测”题库，复习、练习、效果检验一站完成
答案 Answers 1. D. Respiratory status. Rationale: General anesthesia causes relaxation of all muscles, including respiratory muscles, requiring mechanical ventilation. The client’s respiratory status must be monitored closely following general anesthesia. 2. A. Stimulating opiate receptors Rationale: It is the stimulation of cerebral opiate receptors that reduces pain. Excitatory transmitters are not released during administration of morphine. Endorphin release is not associated with narcotic pain relief. The mu receptors mediate analgesia and are not blocked during narcotic administration.
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