不同剂量咪唑安定与异丙酚、芬太尼、维库溴铵联合麻醉诱导的效果比较

A study of the optimal dosage of midazolam in anesthetic induction combined with propofol, fentanyl and vecuronium

目的 探讨不同剂量咪唑安定与异丙酚、芬太尼、维库溴铵联合麻醉诱导的效果并确定咪唑安定的合理用量。方法 80例全麻患者随机分为 4组 , 组咪唑安定 0 .0 5 mg/ kg、 组 0 .1mg/ kg、 组 0 .15 mg/ kg、 组生理盐水对照。按分组静注不同剂量的咪唑安定或生理盐水后依次给予异丙酚 1.5 mg/ kg、芬太尼 3μg/ kg、维库溴铵0 .1mg/ kg麻醉诱导 ,面罩加压供氧后气管插管。观察并记录诱导前、插管前、插管后 1、3、5分钟时的心率、血压指标、术后拔管时间及术后不良反应。结果 组患者插管前血压心率较诱导前下降 , 组患者插管后 1分钟血压升高 (P<0 .0 5 )。 、 组拔管时间较 组延长 (P<0 .0 5 )。 组 1例发生躁动。 组患者插管前后血压、心率平稳 (P>0 .0 5 ) ,无拔管时间延长 (与 组比 ,P>0 .0 5 ) ,未发现不良反应。结论 0 .0 5 m g/ kg咪唑安定与异丙酚、芬太尼、维库溴铵联合诱导效果最佳。

Objective to study the effectiveness of different dosage of midazolam in anesthetic induction combined with propofol,fentanyl and vecuronium,and to confirm the optimal dosage of midazolam Methods 80 patients were randomly divided into 4 groups according to the dosage of midazolam ( 0 05mg/kg in Group Ⅰ,0 1mg/kg in group Ⅱ,0 15mg/kg in group Ⅲ and saline substituted in group Ⅳ) Propofol 1 5 mg/kg,fentanyl 3μg/kg and vecuronium 0 1mg/kg were successively infused following midazolam or saline in each group Tracheal intubation and mechanical ventilation were administered thereafter Monitor and analyze the data of heart rate (HR) and blood pressure (Bp) of induction and intubation,time of extubation,side effects of postoperation Results HR and Bp decreased after induction in group Ⅲ, and Bp increased at time of 1min when intubation finished in group Ⅳ (P<0 05) Extubation was delayed in groupⅡ and Ⅲ than that in group Ⅳ (P<0 05) 1 case underwent fidget in group Ⅲ HR and Bp were stable during induction and intubation in groupⅠ(P>0 05),extubation not delayed contrasted with group Ⅳ (P>0 05),and no side effects found Conculsion Midazolam 0 05mg/kg is the optimal dosage in anesthetic induction combined with propofol 1 5 mg/kg,fentanyl 3μg/kg and vecuronium 0 1mg/kg