长期饮酒对咪达唑仑在无痛气管镜检查中镇静作用的影响

Effects of midazolam on long-time drinking patients in painless bronchoscopy

目的 探讨长期饮酒对咪达唑仑在无痛气管镜检查中镇静作用的影响.方法 176例无痛气管镜检查患者根据是否有饮酒史分为非饮酒组（A组）、饮酒组（B组）;B组患者依据咪达唑仑用量随机分为B1组和B2组.A组和B1组在复合麻醉中咪达唑仑的剂量为0.08 mg/kg;B2组的咪达唑仑剂量为0.1 mg/kg.对患者进行Ramsay镇静分级,观察患者声门开放情况、呛咳、心率变化、血氧饱和度变化、血压变化、术后不良记忆等.结果 各组间在Ramsay镇静分级中差异无统计学意义;B1较A组在检查过程中声门开放更差、心率改变更大、血压变化更大、不良记忆更多;B1组较B2组在检查过程中声门开放更差、心率改变更大、血压变化更大;A组和B2组在所有的观测指标上差异均无统计学意义.结论 长期饮酒可使咪达唑仑在无痛气管镜检查中的镇静作用降低;对长期饮酒患者咪达唑仑用量应增加至0.1 mg/kg.Ramsay镇静分级不适用于无痛气管镜检查中镇静状态的评估.

Objective To research the effects of midazolam in long-time drinking patients which were checked by painless bronchoscopy.Methods One hundred and seventy-six patients were divided to non-drink group （A group） and drink group （B group）,drinking patients were divided into B1 group and B2 group with different dose of midazolam.Midazolam 0.08 mg/kg were used in A group and B1 group,midazolam 0.1 mg/kg were used in B2 group.Patients were classified with Ramsay Sedation score,glottal opening,cough,changes in heart rate,changes in SpO2,changes in blood pressure,bad memories.Results There was no difference of the Ramsay Sedation score in Statistics in three groups,differences were identified in glottal opening,changes in heart rate,changes in blood pressure,bad memories between A group and B1 group.Glottal opening,changes in heart rate and changes in blood pressure were difference in B1 group and B2 group.Observations were no difference in Statistics between A group and B2 group.Conclusions Long-time drinking can reduce effect of midazolam in Painless bronchoscopy,dose of midazolam should be increased to 0.1 mg/kg in long-time drinking patients which checked by painless bronchoscopy.Ramsay Sedation score does not fit to assessment in painless bronchoscopy.