摘要
目的比较重度创伤患者在不同麻醉深度下气管插管时的咪达唑仑用量及血流动力学变化。方法将36例非颅脑损伤的重度创伤患者随机分为A、B两组各18例。所有患者入室行脑电双频指数(BIS)监测,以咪达唑仑1.5mg/min缓慢静注,当BIS达到预定值〔A组(60±3),B组(45±3)〕时立即给予芬太尼3ug/kg,琥珀胆碱1.5mg/kg,肌肉松弛后气管插管。分别记录入室时(T0)、BIS达预定值时(T1)、气管插管即刻(T2)、插管后1min(T3)、3min(T4)的心率(HR)、收缩压(SBP)、BIS和咪达唑仑的用量。结果两组患者入室时HR、SBP、BIS差异均无统计学意义;组内比较A组各时点HR、SBP差异均无统计学意义,B组HR、SBP在T2、T3、T4时点与T0时比较差异有统计学意义;A组的HR、SBP在T3、T4时点与B组相同时点比较差异有统计学意义。咪达唑仑的用量为(0.115±0.014)mg/kg。结论重度创伤患者使用小剂量咪达唑仑麻醉诱导既有利于创伤患者的循环稳定又可使患者处于一个合适的麻醉深度。
Objective To compare midazolam dose and hemodynamic changes in severe trauma patients during tracheal intubation in different depth of anesthesia. Methods 36 cases of severe trauma patients without brain injury were divided into A and B groups （n = 18） randomly. All patients were monitored with bispectral index （ BIS）, midazolam was intravenously injected slowly at the speed of 1.5 mg/min. When the BIS reached the target value （Group A of 60 ±3, Group B of 45± 3） , patients were treated with fentanyl 3ug/kg, suxamethonium 1.5mg/kg immediately, intubation after muscle relaxation. Recorded the HR, SBP, BIS and midazolam dose when entering room （T0 ）, BIS reached target value （T1 ）, tracheal intubation immediately （T2 ）, 1 min （T3 ） and 3min （ T4 ） after intubation . Results There were no statistical significance of HR, SBP and BIS when entering operation room. Compared the value of HR and SBP in each time point in Group A, there was no statistical significance. However, Compared the value of HR and SBP at T2 , T3 , T4 with those at To in Group B, there were significant significance （ P 〈 0.05 ）. Additionally, compared with those in Group B at the same time point, there were significant significance of the HR and SBP in Group A at T3, T4 （ P 〈 0.05 ）. The dose of midazolam was （ 0.115± 0.014） mg/kg. Conclusion A low dose midazolam used in anesthesia induction to the patients with severe trauma, is beneficial to the circulation stability and appropriate anesthesia depth.
出处
《海南医学》
CAS
2009年第5期19-20,9,共3页
Hainan Medical Journal
