丙泊酚和咪达唑仑靶控输注用于椎管内麻醉病人镇静的研究  

The Sedative Effect of Propofol and Midazolam by Target Controlled Infusion During Spinal-epidural Anesthesia

作　　者：井蕊[1] 王建珍[1] 孟尽海[1] 

机构地区：[1]宁夏医学院附属医院麻醉科,银川750004

出　　处：《宁夏医学院学报》2008年第4期437-439,共3页Journal of Ningxia Medical College

摘　　要：目的观察椎管内麻醉辅以持续靶控输注丙泊酚和咪达唑仑的镇静效果。方法在腰硬联合麻醉下择期行下腹部手术的成年病人60例,ASA I^II级,随机分为两组,每组30例,予以丙泊酚(I组)和咪达唑仑(II组)持续靶控输注镇静。分别在入室平卧10min(T1)、静脉给予镇静药后2min(T2)、5min(T3)、10min(T4)、20min(T5)、30min(T6)、手术结束前10min(T7)、手术结束时(T8)8个时间点记录OAA/S镇静评分、BIS值及心率、血压、呼吸和血氧饱和度。结果两组患者生命体征均平稳,与给药前比较,丙泊酚组给药后2、5、10、20和30min BIS值明显下降(P<0.05);OAA/S评分在给药后2min到30min都有明显下降(P<0.05)。咪达唑仑组与给药前比较,给药后5min到30min BIS值明显下降(P<0.05),OAA/S评分也在给药后5min到手术结束前10min都有明显下降(P<0.05)。结论椎管内麻醉辅以丙泊酚、咪达唑仑持续靶控输注镇静效果良好,且对生命体征影响小;BIS值对丙泊酚和咪达唑仑镇静监测反应灵敏。Objective To investigate the sedative effect of Propofol and Midazolam by target controlled infusion in patients undergoing spinal-epidural anaesthesia.Methods Sixty ASA Ⅰ-Ⅱ adult patients scheduled for elective below abdomen surgery under spinal-epidural anaesthesia were randomly divided into two groups.Propofol by target controlled continuously infusion were assigned in groupⅠ. Midazolam by target controlled continuously infusion were assigned in groupⅡ.The alertness/sedation scale（OAA/S）and Bispectral index（BIS）were recorded at 10min after entering operativeroom（T1）and 2 min（T2）,5min（T3）,10min（T4）,20min（T5）,30min（T6）after giving intravenously propofol,midazolam and 10min before operation（T7）,end of operation（T8）.Results BIS and OAA/S score of two groups decreased significantly（P〈0.01）.Vital signs of two groups were stable.Conclusion Propofol and Midazolam by target controlled infusion for sedation in patients undergoing spinal-epidural anaesthesia had good clinical effectiveness and had little effect on vital signs.BIS can be used to monitor sensitively the depth of midazolam-induced and propofol-induced sedation.

关 键 词：丙泊酚 咪达唑仑 脑电双频指数 椎管内麻醉 

分 类 号：R614.4[医药卫生—麻醉学]