摘要
目的探讨右美托咪定与咪达唑仑作为麻醉前用药的镇静效果及对患者记忆功能的影响。方法选择择期手术患者40例,年龄20～60岁,ASAⅠ或Ⅱ级,随机均分为右美托咪定组(A组)和咪达唑仑组(B组)。麻醉前20minA组静脉泵注右美托咪定0.7μg/kg,持续10min;B组静注咪达唑仑0.07mg/kg,所有患者在用药前、用药后10min均观看了内容不同的两张水果图片。记录用药前5min、用药后10min患者OAA/S评分,焦虑视觉模拟/焦虑状态问卷(AVA/SAI)评分和BIS,记录MAP、HR和SpO2,术后24h随访患者对用药前后水果图片的记忆情况。结果用药后10min两组MAP明显低于、HR明显慢于用药前5min(P<0.05或P<0.01),A组HR明显慢于B组(P<0.05)。用药后10min两组OAA/S、AVA/SAI评分和BIS明显低于用药前5min(P<0.05),A组OAA/S评分明显低于B组(P<0.05)。术后24h随访,两组患者对给药前图片西瓜记忆率均为100%,A组对给药后图片香蕉记忆率为95%,明显高于B组的0%(P<0.01)。两组患者未出现寒战和躁动。结论作为麻醉前用药,右美托咪定和咪达唑仑具有良好的镇静作用。右美托咪定对记忆功能几乎无影响,但对HR的干扰更明显。
Objective To observe the effect of sedation and postoperative memory change after dexmedetomidine（Dex） and midazolam（Mid） premedication. Methods Forty adult patients ASA I or III were randomly divided into two groups with 20 each： Dexmedetomidine group（group A） or midazolam group （group B）. In group A, 0.7 μg/kg intravenous Dex was maintained for 10 minutes. In group B, 0. 07 mg/kg Mid was given intravenously. Every patient observed two different fruit pictures before and 10 min after drug administration. The MAP, HR, SpO2, BIS, AVA/SAI scale, OAA/S scale were monitored 5 rain before and 10 minutes after infusion. The memory for pictures was noted 24 h after medication. Results The BIS,OAA/S scale, AVA/SAI scale, HR and MAP 10 min after infusion decreased significantly in both groups （P〈0. 05 or P〈0.01）. HR and OAA/S in group A were lower than those in group B 10 rain after drug administration （P〈0.05）. All the patients remembered the watermelon picture in both groups （the ratio of recall 100%）. Only one patient forgot the banana picture in group A （95%）, but in group B nobody remembered the banana picture（0%）. There was no shivering and delirium in both groups. Conclusion Dex and Mid provide good sedation effect but Mid has anterograde amnesia and Dex can effect HR.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第6期548-550,共3页
Journal of Clinical Anesthesiology
基金
泸州医学院大学生科研资助项目(2011014)
