咪达唑仑对全麻术中知晓显性记忆的影响  

The effect of midazolam on dominance memory in general intravenous anesthesia

作　　者：曹悦琥 兰自侃[2] 焦哲顺[2] 

机构地区：[1]宝鸡市中心医院麻醉科,陕西省宝鸡市721008 [2]陕西省人民医院麻醉科,陕西省西安市710068

出　　处：《中国临床康复》2003年第14期2070-2071,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的全麻过程中患者常出现深痛觉与浅镇静现象,而麻醉医生又难以监测,从而导致术后知晓率日益增多。探讨静脉全麻中小剂量咪达唑仑对术中知晓显性记忆的影响及对术中患者的心理护理。方法腹腔镜胆囊切除术患者323例,随机数字法分组为对照组159例,咪达唑仑组164例,全麻术中所有患者均聆听强度大小和内容相同的音乐片段,术后24h调查患者对术中的知晓情况。结果对照组插管前平均动脉压(MAP)为(14.8±1.3)kPa,插管后(14.4±1.9)kPa,插管前后比较t=1.74,P>0.05。咪达唑仑组插管前MAP(15.0±1.2)kPa,插管后(11.7±1.1)kPa,插管前后比较t=1.72,P>0.05。对照组插管前心率(HR)为(84±10)次/min,插管后(84±10)次/min,插管前后比较t=1.83,P>0.05。咪达唑仑组插管前HR(84±10)次/min,插管后(84±12)次/min,插管前后比较t=1.64,P>0.05对照组有36例患者能回忆起术中曾听到音乐的部分内容,咪达唑仑组无一例患者回忆起听过音乐片段。结论全麻术中应用咪达唑仑能明显抑制术中患者的外显性记忆力,有效地防止术中知晓给患者带来不应有的心理上的不良影响。Aim To explore the effect of micro dosage midazolam on dominance memory and nursing of psychology in patients during intravenous anesthesia operation.Methods According to digital table method, 323 patients, 118 males and 205 females, aged 25-74 years old, undergoing laparoscopic cholecystectomy were randomly divided into midazolam group with 164 cases and control group with 159 cases.All the cases were given the same pieces of music with the same strength during operation and then were asked about the situation during the operation 24 hours after the operation. Results The mean arterial blood pressure(MAP) before and after intubation was (14.8±1.3) kPa and (14.4±1.9) kPa in the control group respectively(t=1.74,P >0.05),(15.0±1.2) kPa and (11.7±1.1) kPa in the midazolam group respectively(t=1.72, P>0.05). The heart rate (HR) before and after intubation was (84±10) times/min and (84±10)times/min in the control group respectively(t=1.83,P >0.05),(84±10)times/min and (84±12) times/min in the midazolam group respectively(t=1.64,P >0.05).36 cases in the control group could recollect partial contents of music while no case in the midazolam group had any memory about the music during the operation.Conclusion Midazolam obviously inhibits dominant memory of patients during the operation, efficiently preventing patients from the psychological harmful effects in the course of the operation.

关 键 词：咪达唑仑 术中 知晓 显性记忆 心理护理 腹腔镜 胆囊切除术 静脉全麻 小剂量 

分 类 号：R614.24[医药卫生—麻醉学]