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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
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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.
出处 《上海医科大学学报》 CSCD 1998年第6期466-467,共2页 Journal of Fudan University(Medical Science)
关键词 异丙酚 咪唑安定 全麻诱导 propofol midazolam anesthesia induction
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