咪唑安定对丙泊酚TCI镇静催眠效应的影响

Effect of Midazolam on Sedation and Hypnosis of TCI Propofol

目的:评价咪唑安定对丙泊酚靶控输注时镇静催眠效应的影响。方法:ASAI-II级择期手术患者60例,随机分为3组:A组为单纯丙泊酚组,B组为咪唑安定0.04 mg/kg+丙泊酚组,C组为咪唑安定0.06 mg/kg+丙泊酚组。A组直接靶控输注丙泊酚,B组和C组分别输注咪唑安定0.04 mg/kg或0.06 mg/kg,8 min后血浆靶控输注丙泊酚。记录丙泊酚效应部位浓度为1、2、3、4、5 ug/ml时BIS值和OAA/S评分,并记录OAA/S评分达到4、3、2、1时丙泊酚效应部位深度和BIS值。结果:①随丙泊酚浓度升高3组患者BIS值和OAA/S评分逐渐下降。②相同丙泊酚浓度时BIS值和OAA/S评分随咪唑安定剂量增加呈降低趋势。③B、C二组患者OAA/S评分达到3、2、1所需丙泊酚效应部位浓度均显著降低于A组。达到相同OAA/S评分C组所需丙泊酚效应部位浓度显著低于B组。结论:预先给予咪唑安定能显著降低丙泊酚靶控浓度以达到需要的镇静深度。随咪唑安定剂量加大,降低作用越明显。

Objective：To evaluate the affect of midazolam on sedation and hypnosis of TCI propofol. Methods ：60 patients with ASA in grade I to II ware enrolled and randomly divided into 3 groups. Group A received TCI propofol alone. Group B and group C received midazolm 0.04 mg/kg and 0.06mg/kg before TCI propofol respectively. OAA/S and bispectral index （BIS） were recorded when effective - site concentration i CEc） of propofol reached 1, 2, 3, 4, 5 ug/ml. Cec and BIS of propofol were recorded when OAA/S reached 4, 3, 2, lscora. Results： （1）BIS and OAA/S decreased with increasing CEC of propofol in all groups. （2）At the same CEC of propofol, BIS and OAA/S decreased with the increasing CEC of midazolam （3）CEC of proplfol was lower in group Band group C than that in group a when OAA/S were 3, 2, 1 score. CEC of propofol was loup C than that in group B when OAA/S reached the same score. Conclusions： Midazolam significantly decreases CEC of propofol for the same depth of sedation. The effect is augmented with the increasing dose of midazolam.