摘要
目的:观察静脉全麻中靶控输注不同剂量咪唑安定对丙泊酚有效靶浓度的影响。方法:60例ASAI～Ⅱ级的择期腹部手术病人随机分为三组:丙泊酚组(P组)、咪唑安定工组(M1组)、咪唑安定Ⅱ组(M2组),每组20例。M1、M2组均在咪唑安定0.05 mg·kg^(-1)静脉注射后,才艮据组别启动咪唑安定微量泵,剂量M1组为0.04 mg·kg^(-1)·h^(-1);M2组为0.08 mg·kg^(-1)·h^(-1)。三组均直接启动丙泊酚TCI,主要手术操作结束时停止咪唑安定静脉注射,缝皮时停止丙泊酚TCI。每隔5 min记录丙泊酚效应室靶浓度,病人苏醒时间、苏醒情况。结果:在相同镇静深度(SE值相同),随着咪唑安定剂量增力口,丙泊酚有效靶浓度由P组至M1组和M2组逐渐降低,组间差异显著(P<0.05);麻醉苏醒时间逐渐延长,但组间差别不明显(P<0.05):苏醒后OAA/S评分P组较M1组和M2组明显高(P<0.05):术后恶心呕吐等并发症各组间差别无统计学意义(P>0.05),但咪唑安定组术后嗜睡发生率高(P<0.05)。结论:咪唑安定可降低丙泊酚有效靶浓度,且丙泊酚有效靶浓度随着咪唑安定剂量的增加而降低。以0.08 mg·kg^(-1)·h^(-1)的剂量靶控输注咪唑安定可明显减少丙泊酚的用量,且对术后苏醒时间无明显影响,为较适宜的麻醉复合用药方案。
Objective：To observe and compare the influence of target-controlled infusion of different doses of midazolam on the effective target concentration of propofol. Metheds： Sixty ASA Ⅰ-Ⅱ patients undergoing elective surgery, randomize divided into three groups（n=20 each）： propofol group（group P）, midazolam Ⅰ group（group M1 ） and midazolam Ⅱ group（group M2 ）. Berore propofol induction,midazolam （0.05 mg·kg^-1）was intravenously injected followed by two doses of midazolam （0.04 mg·kg^-1·h^-1 in group M1, 0.08 mg·kg^-1·h^-1 in group M2）. At the end of mostly operates stoped midazolam infusion, at the time of sewing skin stopped Propefol infusion and gave atropine and neostigmine to reversing muscle Paralysis.The effective Propofol concentration was noted every 5 min, the time of e- mergence from anesthesia and OAA/S scores were recorded in each group. Results： Along with the increase of the mi- dazolam doses, the required effective propofol concentration was significant decreased （P〈0.05）.Although the times of emergence from anesthesia were increased, there were no significant differences among the three groups（P〈 0.05 ）.OAA/S scores were higher in the group than in groups M1 and M2（P〈0.05 ）, and the Post operative sleepiness was more common in the midazolam groups （P〈0.05）.There was no significant difference in the occurrence of the adverse reactions among the three groups（P〉0.05 ）. Conclusion：There was a dose-dependent decrease in the effective propefol concentration when midazolam doses were increased. For Propofol based anesthesia used for surgery, continuous intravenous infusion of Midazolam at the dose of 0.08 mg·kg^-1·h^-1is the optimal combination of these tw anesthetics.
出处
《新疆医学》
2013年第3期34-37,共4页
Xinjiang Medical Journal
