阿片类吸毒患者围术期麻醉处理现状

中国临床药理学与治疗学 ›› 2013, Vol. 18 ›› Issue (5): 592-596.

阿片类吸毒患者围术期麻醉处理现状

邵怡^1,2, 金孝岠², 郭建荣¹

¹第二军医大学上海浦东公利临床医学院麻醉科,浦东 200135,上海;
²皖南医学院附属弋矶山医院麻醉科,芜湖 241001, 安徽

收稿日期:2013-01-11 修回日期:2013-02-21 出版日期:2013-05-26 发布日期:2013-05-22
通讯作者: 郭建荣,男,博士,主任医师,研究方向:血液保护。Tel: 13671834826 E-mail: Jianrguo@126.com
作者简介:邵怡,女,硕士,医师,研究方向:临床麻醉与应激。Tel: 15000231269 E-mail: lsdsy05@163.com

Perioperative anesthetic management and medication status quo on patients with opioid drug abuse

SHAO Yi ^1,2, JIN Xiao-ju², GUO Jian-rong¹

¹Second Military Medical University, Shanghai Pudong Gong Li School of Clinical Medicine,Pudong New Area 200135,Shanghai,China;
²Department of Anesthesiology,Yijishan Hospital of Wannan Medical College,Wuhu 241001,Anhui,China

Received:2013-01-11 Revised:2013-02-21 Online:2013-05-26 Published:2013-05-22

摘要/Abstract

摘要： 长期以来,吸毒问题都是严重威胁人类生存的全球性公害之一。近年来我国吸毒者的数量始终居高不下,需要手术麻醉的吸毒患者也日益增多。吸毒患者的麻醉问题对麻醉医生无疑也是一大挑战,整个围术期的麻醉诊疗工作都相对复杂和困难,其中麻醉用药问题尤为棘手。因此,作为麻醉医生,需全面了解吸毒对人体的影响及吸毒患者麻醉处理的相关问题。本文就阿片类吸毒对人体影响及吸毒患者的围术期麻醉处理作一简述。

关键词: 吸毒, 围术期, 麻醉药物, 麻醉处理

Abstract: For a long time,the problem of drug abuse is a serious threat to human survival,which is　also one of the global public nuisances.In recent years the number of drug abuse in China has always been high and the number of drug abuse patients requiring surgical anesthesia is increasing.The anesthesia of patients with drug abuse is no doubt a big current challenge to anesthesiologists.The entire perioperative clinics are relatively complex and difficult,which the anesthetic drug problem is particularly knotty.Therefore,anesthesiologists should fully understand the drug effects on the body and the anesthesia management related issues.This paper summarized the drug effects on the body and the perioperative anesthsia management.

Key words: Drug abuse, Perioperative period, Anesthetic drugs, Anesthesia management

中图分类号:

R614

邵怡, 金孝岠, 郭建荣. 阿片类吸毒患者围术期麻醉处理现状[J]. 中国临床药理学与治疗学, 2013, 18(5): 592-596.

SHAO Yi , JIN Xiao-ju, GUO Jian-rong. Perioperative anesthetic management and medication status quo on patients with opioid drug abuse[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(5): 592-596.

参考文献

[1] Vazquez MM,Una OR.Anesthesia in drug addiction[J].Rev Esp Anestesiol Reanim,2011,58(2):97-109.
[2] Henriksen G,Willoch F. Imaging of opioid receptors in the central nervous system[J].Brain,2008,13(1):1171-1196.
[3] 文迪,马春玲,丛斌,等.CCK-8与内源性阿片系统在吗啡依赖中的相互作用[J].中国药理学通报,2010,26(11):1445-1450.
[4] 杨良.海洛因滥用对循环系统的损害及生理病理变化[J].中国药物滥用防治杂志,2001,59(2):7-11.
[5] 余红胜.海洛因依赖者并发呼吸系统疾病500例分析[J].中国药物滥用防治杂志,2007, 13(3): 161-162.
[6] Guo RL,Zhao NX, Ren QY, et al. Study onopioidaddicts,hypothalamus-pituitary-gonadaxis,SOD and MDA contents, and the relation with“deficiency of kidney”[J].Disan Junyi Daxue Xuebao( Acta Acad Med Mil Tert),2002, 24( 7) :849- 850.
[7] 赵宁侠,郭瑞林, 任秦有, 等.阿片类毒品对人体自由基、内分泌激素及细胞免疫的影响 [J].中国临床康复,2003,7(5):764-765.
[8] Hernandez M,Birnbach DJ,Van ZA.Anesthetic management of the illicit-substance-using patient[J].Curr Opin Anaesthesiol,2005,18(3):315-324.
[9] 柳培雨,田毅.常见吸毒患者的临床麻醉处理[J].医学与哲学:临床决策论坛版,2011,32(8):43-44.
[10] Kenna GA,Nielsen DM,Mello P,et al.Pharmacotheraphy of dual substance abuse and dependence[J].CNS Drugs,2007,21(3):213-237.
[11] Lois F,DeKock M. Something new about ketamine for pediatric anesthesia[J] ? Curr Opin Anaesthesiol,2008,21(3):340-344 .
[12] Kohrs R,Durieux ME. Ketamine: teaching an old drug newtricks[J].Anesth Analg,1998,87(7): 1186-1193.
[13] Fabregat-Cid G,Asensio-Samper JM.Postperative pain management for patients who are long-term users of opioidl[J].Rev Esp Anestesiol Reanim,2011,58(1):25-33.
[14] 刘端政,章颂,刘燕玲,等.长托宁复合氯胺酮用于吸毒患者的临床麻醉研究[J].中国医药指南,2012,10(8):327-328.
[15] 郭立志,任进民.常用选择性环氧合酶-2抑制剂的临床研究进展[J].实用疼痛学杂志,2008,4(6): 445-450.
[16] 崔旭蕾,郭向阳,任洪智.非甾体抗炎药及其心血管风险[J].临床麻醉学杂志, 2007,23(3): 256-257.
[17] Malan TP Jr,Marsh G, Hakki SI, et al. Parecoxib sodium, aparenteral cyclooxygenase　2　selective　inhibitor,improves motphine analgesia and is opioid-sparing following total hip arthroplasty[J].Anesthesiology,2003,98(4): 950-956.
[18] 赵静.预注帕瑞昔布对子宫切除患者术后镇痛的影响[J].实用医学杂志,2010,26(5): 839-840.
[19] Bettelli G.Preoperative evaluation in geriatric surgery:comorbidity unctional status and pharacological history[J].Minerva Anestesiol,2011,77(6):637-646.
[20] 黄宏辉,乔瑞冬.药物成瘾性患者术中出现戒断症状的麻醉处理[J].河北医学,2006,12 (9) :856－858.
[21] Kuczkowski KM.Anesthetic implications of drug abuse in pregnancy[J].J Clin Anesth,2003,15(5):382-394.
[22] Cavaliere F,Iacobone E,Gorgoglione M,et al.Anesthesiologic preoperative evaluation of drug addicted patient [J].Minerva Anestesiol,2005,71(6):367-371.
[23] Smith H,Bruckenthal P.Implications of opioid analgesia for medically complicated patients[J].Drugs Aging,2010,27(5):417-433.
[24] 王品,龙云,佟波涛,等.帕瑞昔布钠在戒毒期吸毒患者术后镇痛中的临床观察[J].临床麻醉学杂志,2011,27(10):1021-1022.
[25] Jamison RN,Ross EL,Machna E,et al.Substance misuse treatment for high-risk chronic pain patients on opioid therapy:a randomized trial[J].Pain, 2010,150(5):390-400.