臂丛神经阻滞时咪达唑仑清醒镇静的研究

Research of Target-controlled Infusion of Midazolam on Conscious Sedation for Patients Undergoing Brachial Plexus Nerve Block

目的 探讨咪达唑仑靶控输注 (TCI)系统用于臂丛神经阻滞患者清醒镇静的可行性及中国人咪达唑仑清醒镇静靶控血药浓度。方法 对 4 0例ASAⅠ～Ⅱ级择期在臂丛神经阻滞下行上肢手术的患者 ,运用警觉 /镇静(OAA/S)评分和脑电双频指数 (BIS)评估镇静深度。采用咪达唑仑TCI行清醒镇静 ,以血浆室为靶控目标 ,确定相应靶控血药浓度及其与BIS相关性。结果 深度清醒镇静 (OAA/S评分 3分 )时所需靶控血药浓度为 (118 0± 10 8)ng/ml。BIS与TCI血药浓度 (Cp)具有良好的相关性 ,BIS =- 3 0 3Cp +35 2 2 7(r =- 0 885 4 ,P <0 0 1)。结论 咪达唑仑靶控输注系统用于臂丛神经阻滞患者清醒镇静可控性良好 ,镇静深度适宜 ,对血流动力学和呼吸功能无明显影响 ,适宜临床推广应用。

Objective To confirm the feasibility of target-controlled infusion of midazolam on conscious sedation for patients undergoing brachial plexus nerve block and the needed target-controlled blood concentration. Methods Forty patients undergoing brachial plexus block were subjected to target-controlled infusion of midazolam. The OAA/S score, Cp, BIS, HRV,MAP, HR, SpO 2 were observed. Results When OAA/S score was 3, the required target-controlled blood concentration of midazolam was 118.0±10.8 ng/ml in midazolam sedation patients. There was a good correction between BIS and Cp. Conclusion Target-controlled infusion of midazolam on conscious sedation for patients undergoing brachial plexus block has some advantages and can be applicable to clinical use.