异丙酚复合咪唑安定全麻诱导的临床效果

Effectiveness of propofol combined with midazolam in induction of anesthesia

目的 :比较异丙酚与异丙酚复合咪唑安定用于全麻诱导的效果。方法 :6 0例ASAI～II级颅脑手术患者随机分为两组 :异丙酚组 (A组 )和异丙酚复合咪唑安定组 (B组 )。麻醉诱导开始 ,静滴芬太尼 2 μg/kg后 1分钟 ,A组静注异丙酚1.6mg/kg ,B组静注咪唑安定 0 .1mg/kg和静注异丙酚 1mg/kg;两组均静注万可松 0 .16mg/kg ;2分钟后行气管插管。记录麻醉诱导前、静滴芬太尼后、气管插管前和气管插管后两组患者心率、收缩压、舒张压、血氧饱和度及双频指数变化。结果 :麻醉诱导药静注后 ,气管插管前A组收缩压 (12 .39± 0 .5 7kPa)与B组收缩压 (13.70± 1.12kPa)相比有所下降 ;低血压发生率A组为 40 %而B组为 6 %(P <0 .0 1)。气管插管前B组双频指数 (5 5 .3± 2 .8)低于A组双频指数 (5 9.3± 3.2 )。结论 :B组麻醉诱导是比A组更能保持足够麻醉深度和心血管稳定并能产生遗忘作用的联合麻醉诱导方法。

Objective:To compare the effect of intravenous injection of propofol with propofol combined with midazolam in the induction of general anesthesia before tracheal intubation. Methods:Sixth patients undergoing ASA-Ⅱ cerebral operation were randomly allocted into two groups:propofol group(Group A)and propofol combined with midazolam group(Group B).At the begining of induction of anesthsia,one minute after intravenous dripping fentanyl 2μg/kg,patients of Group A were given propofol 1.6mg/kg intravenously and patients of Grop B wre given midazolam 0.1mg/kg and propofol 1mg/kg intravenously.Patients in both groups received vecuronium 0.16mg/kg iv,and 2 minutes later tracheal intubation was done.Heat rate,systolic pressure,diastolic pressure,blood oxygen saturation and double frequency index were recorded during the period before the induxtion of anesthesia,after iv fentany1,before and aftertrachal intubation.Results:After intravenous injection of anesthesia induction drugs systolic pressure of Group A(12.39±0.75kPa) were lower than that of Group B(13.70±1.12kPa),the incidence of hypotension was 40% in Group A and 6% in Group B.Before tracheal intubation,the double frequency of Group B(55.3±2.8)was lower than that of Group A(59.3±3.2).Conclusion:In induction of anesthesia,method of Group B is superior to that of Group A in maintaining adequate anesthesia ldepth and cardiovascular stability and is the method that may cause amuesia.