小剂量咪达唑仑辅助异丙酚麻醉在短时程手术中的应用

Application of small dose midazolam combine with propofol in short-term operation

目的探讨小剂量咪达唑仑(10μg.kg-1)辅助异丙酚麻醉用于短时程手术时,对异丙酚诱导浓度、时间和觉醒时间的影响。方法 30例腰麻下行泌尿外科手术的男性患者分为安慰剂-异丙酚-安慰剂组(PP组)、咪达唑仑-异丙酚-安慰剂组(MP组)和咪达唑仑-异丙酚-氟马西尼组(MF组),每组10例。记录3组异丙酚诱导剂量、时间、浓度,以及觉醒时间和浓度并进行比较。结果 MP组诱导剂量、诱导浓度和觉醒浓度低于PP组,诱导时间和总时间短于PP组(P<0.05)。MF组诱导剂量和诱导浓度低于PP组,诱导时间、觉醒时间和总时间短于PP组(P<0.05)。MF组觉醒时间和总时间短于MP组,觉醒浓度高于MP组(P<0.05)。结论小剂量咪达唑仑复合异丙酚麻醉用于短时程手术,可显著降低异丙酚诱导时的用药剂量和麻醉时间。

Objective To evaluate the effect of small dose of midazolam（10 μg·kg-1） combined propofol on induction concentration,induction time,and awakening time in short-term operation;and explore the antagonistic effect of flumazenil.Methods Thirty male patients who underwent urological operation under spinal anesthesia were divide into placebo-propofol-placebo group（PP group）,midazolam-propofol-placebo group（MP group） and midazolam-propofol-flumazenil group（MF group）,ten patients in each group.The induction dose,induction time,induction concentration,awakening time and plasma concentration of propofol in three groups were recorded and compared.Results The induction dose,induction concentration and awakening concentration of MP group were significantly lower than those of PP group;the induction time and total time of MP group were significantly shorter than those of PP group（P〈0.05）.The induction dose,induction concentration of MF group were significantly lower than those of PP group;the induction time,awakening time and total time of MF group were significantly shorter than those of PP group（P〈0.05）.The awakening time and total time of MF group were significantly shorter than those of MP group;the awakening concentration was significantly higher than that of MP group（P〈0.05）.Conclusion The small dose midazolam combined with propofol in short-term operation can decrease the induction dose and duration of anesthesia of propofol.