异丙酚、咪唑安定在全麻诱导中的联合应用  

THE COMBINATION OF PROPOFOL AND MIDAZOLAM IN INDUCTION OF ANESTHESIA

作　　者：曹晓莹[1] 顾华华[1] 沈雅芳 梁伟民[1] 严惠昌[1] 

机构地区：[1]上海医科大学华山医院麻醉科

出　　处：《上海医科大学学报》1998年第6期466-467,共2页Journal of Fudan University(Medical Science)

摘　　要：比较异丙酚、咪唑安定或两药联合应用在全麻诱导中的效应。方法３６例无心血管疾病、年龄＜６０岁（２０～５７岁）的择期全麻手术病人，随机分为４组。Ⅰ组采用异丙酚２．０ｍｇ／ｋｇ，Ⅱ组采用异丙酚２．５ｍｇ／ｋｇ，Ⅲ组采用咪唑安定０．３ｍｇ／ｋｇ，Ⅳ组采用异丙酚１．５ｍｇ／ｋｇ合并咪唑安定０．１ｍｇ／ｋｇ，辅以芬太尼、维库溴胺诱导插管。观察各组的起效时间及诱导、插管后的循环变化。结果单独采用异丙酚或咪唑安定诱导后，血压下降明显，且异丙酚２．０ｍｇ／ｋｇ不足于抑制插管应激反应，另咪唑安定起效慢；异丙酚合并咪唑安定组诱导起效快，与异丙酚组相比无差异，诱导后循环变化小，能有效抑制插管应激反应。结论异丙酚１．５ｍｇ／ｋｇ合并小剂量咪唑安定（０．１ｍｇ／ｋｇ）用于麻醉诱导，诱导迅速、循环稳定、效果确切，是一种较为合理的麻醉诱导方法。PURPOSE To compare the effect of propofol, midazolam and propofol combined with midazolam in induction of anesthesia. METHODS 36 non-cardiovascular disease patients under sixty-year old were randomly divided into four groups. Each group was given different iv anesthesia drugs for induction (group Ⅰ: propofol 2.0mg/kg, group Ⅱ: propofol 2.5mg/kg, group Ⅲ: midazolam 0.3mg/kg, group Ⅳ: propofol 1.5mg/kg combined with midazolam 0.1mg/kg). HR and MAP were recorded at the following times: before induction (To), just before intubation (T 1) and 1 (T 2), 3(T 3), 5(T 4) minutes after intubation. The onset times of drugs were also recorded. RESULTS The comparison of To with T 2, T 3 showed that the HR increased ( P <0.05) in group Ⅰ and did not change significantly in other groups. The HR did not change significantly in any group in comparison of To with T 1, T 4. After induction, MAP decreased ( P <0.05) in group Ⅳ, decreased significantly ( P <0.001) in group Ⅲ and decreased much significantly ( P <0.001) in groups Ⅰ, Ⅱ. The MAP increased ( P <0.05) in group Ⅰ and decreased significantly ( P <0.01) in groups Ⅱ, Ⅲ but did not change significantly in group Ⅳ after intubation. The onset time of midazolam was longer than the other groups ( P <0.01). CONCLUSIONS Propofol 1.5mg/kg combined with midazolam 0.1mg/kg is a useful dose for ansthesia induction that make stable circulation and quick onset.

关 键 词：异丙酚 咪唑安定 全麻诱导 

分 类 号：R614.2[医药卫生—麻醉学]