期刊文献+

国产地西泮与咪唑安定对胸段硬膜外阻滞后呼吸动力学影响的对比研究 被引量:7

A comparison of the effect of home-made diazepam and midazolam on respiratory mechanics during epidural block
下载PDF
导出
摘要 目的 比较不同剂量的国产地西泮、咪唑安定对胸段硬膜外腔阻滞后呼吸动力学与通气功能的影响 ,以推荐合适的咪唑安定剂量 ,供临床参考应用。方法 择期手术病人 68例 ,随机分为四组 ,每组 17例。硬膜外腔穿刺点为T6~ 7、T8~ 9;阻滞平面上界达T2 ~T5,下界为T10 ~L1。所有病人先给予氟芬合剂 0 0 3ml/kg ;15分钟后分别静注地西泮 0 1mg/kg(D1组 )与 0 15mg/kg(D2组 )、咪唑安定 0 1mg/kg(M1组 )与 0 15mg/kg(M2组 )。于静注氟芬合剂后地西泮或咪唑安定前、地西泮或咪唑安定后 5、10、15、2 0、2 5、3 0、3 5分钟时 ,将通气功能、呼吸动力学参数的 5分钟平均值进行统计学处理。结果  ( 1)静注两种不同剂量的地西泮或咪唑安定前、后各时点及四组间呼吸频率、吸、呼气峰流速 ,压力 时间乘积 ,食管压力 (胸腔内压 ) ,气道平均压 ,PEEP ,内源性PEEP ,吸气时间比值 ,频率 /潮气量比值的变化差异不显著 (P >0 0 5 )。 ( 2 )静注地西泮或咪唑安定后 ,吸、呼气潮气量、分钟通气量、吸气峰压、呼吸驱动力、气道阻力及病人呼吸做功较静注前显著增高或增加 ;动态顺应性显著下降 (P <0 0 5 ) ;但静注两种不同剂量地西泮或咪唑安定后四组间各时点此类参数变化差异均无统计学意义 (P >0 0 5 )。 Objective To compare the effect of home made diazepam and midazolam on respiratory mechanics during epidural block.Methods Sixty eight patients were randomly divided into four groups( n= 17),group D1:diazepam 0 1mg/kg,group D2:diazepam 0 15mg/kg,group M1:midazolam 0 1mg/kg and group M2:midazolam 0 15mg/kg.The parameters of ventilation function and respiratory mechanics were detected before and 5?10?15?20?25?30?35min after intravenous injection diazepam and midazolam.Results The respiratory rate,peak inspiratory and expiratory flow rate,pressure time product,esophageal pressure,mean airway pressure,PEEP,intrinsic PEEP,inspiratory time ratio,frequency/tidal volume had no statistical significant differences each time point before and after intravenous injection diazepam,midazolam and among four groups ( P> 0 05).After intravenous injection diazepam and midazolam the inspiratory and expiratory tidal volume,minute ventilation,peak expiratory pressure,respiratory drive,airway resistance,work of patient breathing significantly increased and the dynamic compliance markedly decreased than before intravenous injection ( P< 0 05).But after intravenous injection diazepam and midazolam,there were not statistical differences in the above parameters of each time point among four groups ( P> 0 05).Conclusion Intravenous injection the home made diazepam and midazolam≤0 15mg/kg,the effects of them on ventilation function and respiratory mechanics were no discrepant during epidural block.
出处 《临床麻醉学杂志》 CAS CSCD 2002年第3期136-138,共3页 Journal of Clinical Anesthesiology
关键词 硬膜外阻滞 地西泮 咪唑安定 呼吸功能 呼吸动力学 Epidural block Diazepam Midazolam Ventilation function Respiratory mechanics
  • 引文网络
  • 相关文献

参考文献5

  • 1Reves JG,Glass PSA,Lubarsky DA.Nonbarbiturate intravenous anesthetics In:Miller RD,eds.Anesthesia.5th ed.New York:Churchill Livingstone,2000.233-234.
  • 2Forster A,Gardaz JP,Suter PM,et al.Respiratory depression by midazolam and diazepam.Anesthesiology,1980,53:494-498.
  • 3Sunzel M,Paalzow L,Berggren L,et al.Respiratory and cardiovascular effects in relation to plasma leels of midazolam and diazepam.Br J Clin Pharmacol,1988,25:561-564.
  • 4Gross JB,Zebrowski ME,Carel WD,et al.Time course of ventilatory depression after thiopental and midazolam in normal subjects and in patients with chronic obstructive pulmonary disease.Anesthesiology,1983,58:540-544.
  • 5Brodgen RN,Goa KL.Flumazenil.Drugs,1991,42:1061-1064.

同被引文献14

引证文献7

二级引证文献6

;
使用帮助 返回顶部