咪唑安定在局麻手术病人行清醒镇静的剂量探讨

The ideal dose of midazolam for Conscious sedation in local anesthesia

目的 :观察静注或肌注不同小剂量咪唑安定在局麻手术的镇静效果、安全性及其适宜剂量。方法 :45例病人随机分 3组 (每组 1 5人 ) ,术前静注咪唑安定 0 0 2mg/kg(A组 )、0 0 3mg/kg(B组 )、肌注 0 0 3mg/kg (C组 )。分别记录用药前、用药后 1 ,3 ,5 ,1 0 ,1 5 ,2 0 ,30 ,60分钟的BP、HR、RR、SpO2 、焦虑及镇静状态。结果 :3组用药后均有抗焦虑作用 (P <0 0 5) ;镇静作用B组强于A、C组 (P <0 0 5) ;医生评价均较满意 ;病人自我感受良好 ,合作均好 ,均无不良反应。 3组BP、HR、RR、SpO2 变化组间比较无显著差异 ,用药前后变化无显著差异。结论 :咪唑安定行清醒镇静的最小剂量为 0 0

Objective:To find out the suitable dose of midazolam for conscious sedation in local anesthesia and to observe its sedation and safety Methods:Forty-five patients were randomly divided into three groups,Group A:intravenous midazolam 0 02 mg/kg( n =15);Group B:intravenous midazolam 0 03 mg/kg( n =15);Group C:intramuscular midazolam 0 03 mg/kg( n =15) BP,HR,RR,SpO 2 sedation and anxiolysis were recorded before administration and 1,3,5,10,10,20,30,60 min after administration Meanwhile,patients cooperation,amnesia,procedure,therapy efficacy and side effects were evaluated Results:the anxiolytic effect was observed in three groups;the sedation of group B is stronger than that of group A and C( P <0 05);Surgeons were all satisfied with the procedures Patients selves assessments of group B were better than those of group A and C ( P <0 05) No side effects and amnesia were recorded There were no significant differences in BP,HR,RR,SpO 2 between premeditation and after administration in three groups Conclusions:0 03 mg/kg I V of premeditative midazolam may be the minimal dose for conscious sedation in local anesthesia