咪达唑仑对颅内压的影响

Influence of medazolam on the intracranial pressure

目的评价咪达唑仑对神经外科病人颅内压的影响。方法13例颅内胶质瘤成年病人ASAⅠ~Ⅱ级,择期行开颅手术。在麻醉诱导时,静注咪达唑仑2 mg/kg。分别于注药前、后1、2、3、5、7、10、15和20 min,观察收缩压（SP）,舒张压（DP）,平均动脉压（MAP）,心率（HR）,脑灌注压（CPP）,颅内压（ICP）的变化。颅内压监测采用腰蛛网膜下腔置管直接测压。结果静注咪达唑仑后SP,MAP,CPP显著降低（15.18±2.21）kPa降至（13.44±1.56）kPa,（11.33±2.14）kPa降至（9.54±1.70）kPa,（9.05±2.46）kPa降至（7.97±2.14）kPa。但随时间延长20 min内恢复至基础水平,DP、HR给药前后无明显变化,ICP给药后明显下降且在观察期内无回升趋势。结论咪达唑仑能降低病人的颅内压,适用于神经外科麻醉,对颅内压增高病人应适当调整用量。

Objective To evaluate the intracranial pressure（ICP）changes of neurosurgery patient after intravenous medazolam injection.Methods ICP was measured by directly subarachnoid space tube inserted.After medazolam 2 mg/kg intravenous injection,systolic pressure（SP）,diastolic pressure（DP）,mean arterial pressure（MAP）,cerebral perfusion pressure（CPP）and ICP were determined 1,2,3,5,7,10,15 and 20 minutes after the injection.Results SP,MAP and CPP were decreased significantly after medazolam injection（from（15.18±2.21）to（13.44＋1.56） kPa,（11.33±2.14）to（9.54±1.70） kPa and（9.05±2.46）to（7.97士2.14）kPa,respectively）,but they recovered to normal level later.While DP and HR had no significant change.ICP also decreased（from（0.26±1.40）to（1.57＋1.22）kPa）and was kept at the low level during whole observation.Conclusion Medazolam can decrease patients＇ ICP and may be an efficient anesthetic for neurosurgery.