氟哌利多与咪达唑仑辅助镇静对患者内隐记忆的影响

Effect of droperidol, midazolam conscious-sedation on im-plicit memory in epidural anesthesia

目的:比较氟哌利多与咪达唑仑在硬膜外麻醉辅助镇静中消除内隐记忆的作用。方法:32例硬膜外麻醉患者,随机分为D、M2组,D组应用氟哌利多2.5mg加芬太尼0.05mg辅助镇静,M组应用咪达唑仑3mg加芬太尼0.05mg辅助镇静,用药10min后采用加工分离程序结合词干补笔法的方法测试2组患者的外显记忆和内隐记忆成绩。同时评定患者的改良警醒/镇静评分。结果:D组和M组患者改良警醒/镇静评分的中位数分别为4分和3分,与M组相比,D组外显记忆成绩较高,同时内隐记忆成绩较低,但并未完全消失,D组进一步增加氟哌利多的剂量患者会出现呼吸抑制。结论:氟哌利多对内隐记忆的抑制有相对的特异性,但在抑制内隐记忆的同时也引起呼吸抑制,这限制了硬膜外辅助镇静中氟哌利多对内隐记忆的完全消除。

Objective： To compare the effects of droperidol, midazolam sedation on implicit memory in patients under epidural anesthesia. Methods： Thirty- two patients with ASA Ⅰ - Ⅱundergoing general surgery operations with epidural anesthesia were divided into 2 groups,group D received droperidol 2.5mg and fentanyl 0.05mg as sedative, group M received midazolam 3mg and fentanyl 0.05 mg as sedative. The explicit memory and implicit memory scores were gained by methods of process dissociation procedure, and the patients＇ assessment of alertness/sedation scales were graded simultaneouly. Results： The median of patient＇ assessment of alertness/ sedation scale in group D and group M were 4 and 3 respectively. Patients in group D had higher explicit memory scores and lower implicit memory scores than those in group M. But the implicit memory had not disappeared completely in group D. Respiratory depression emerged when increasing the dosage of droperidol. Conclustion： Droperidol can specifically depress the implicit memory, but it results in respiratory depression when the dosage of droperidol increased. It limits the usage of droperidol to eliminate the implicit memory completely.