咪唑安定清醒镇静用于纤支镜检查及最佳剂量的探讨

THE EFFECT AND OPTIMAL DOSE OF MIDAZOLAM ON CONSCIOUS SEDATION FIBREOPTIC BRONCHONSCOPY

目的 :研究度冷丁 5 0mg配伍不同剂量的咪唑安定用于支纤镜的镇静作用及对呼吸循环的影响 ,并探讨其最佳剂量。方法 :12 0例拟行支纤镜检患者 (ASAⅠ～Ⅱ级 ) ,随机分为对照组、度冷丁 5 0mg +咪唑安定 0 .0 4mg/kg、度冷丁 5 0mg +咪唑安定 0 .0 6mg/kg三组 ,观察其镇静分级 ,检查过程中的感受情况、遗忘程度 ,检查后的满意度 ,并记录检查中脑电图双频指数分析 (BIS值 )、血压、脉搏血氧饱和度及心电图的变化。结果 :与对照组相比 ,度冷丁 5 0mg +咪唑安定 0 .0 6mg/kg组的效果明显优于未用药组和度冷丁 5 0mg +咪唑安定0 .0 4mg/kg组 ,其镇静程度明显 ,遗忘程度高 ,对呼吸循环功能影响较小。结论 :度冷丁 5 0mg +咪唑安定 0 .0 6mg/kg用于清醒镇静支纤镜检是安全有效的 ,且为最佳剂量。

Objective:To study the effects and optimal dose of the dolantin adding midazolam in fibreoptic bronchoscopy on conscious sedation, respiratory and circulatory function.Methods:One hundred and twenty out patients undergoing fibreoptic bronchoscopy were randomly divided into three groups. The control group (groupⅠ) was not given dolanfine and midozalam The other two groups were intravenously given dolantin 50mg adding midozalam 0.04mg/kg (group Ⅱ )or 0.06mg/kg (group Ⅲ ) respectively. The sedative scores, BIS, amnesia, MAP,HR and SpO 2 were measured.Results:There were significant differences in sedative and amnesia degree between group Ⅲ and group Ⅱ or group Ⅰ ( P <0.01).Effect of dolantin 50mg adding midozalam 0.06mg/kg on respiratory and circulatory systems were small. Conclusions: Dolantin 50rug adding midazolam O06mg/mg could produce safe and effective sedation and be optimal dose in fibreoptic bronchoscopy.