摘要
目的 :比较不同剂量咪唑安定与异丙酚联合诱导时协同作用是否呈剂量相关。以及分别用意识和双频谱指数 (BIS)作为观察指标 ,二者的结果是否一致。方法 :40例ASAⅠ -Ⅱ级行择期手术患者 ,随机分为4组 ,每组10例 ,Ⅰ组生理盐水1ml对照 ,Ⅱ组咪唑安定0.02mg/kg,Ⅲ组咪唑安定0.04mg/kg,Ⅳ组咪唑安定0.06mg/kg,各组病人给予相应剂量咪唑安定 ,1min后使用微量泵持续静注异丙酚1200mg/h ,记录病人意识消失 (指令反应消失 )和BIS降至50时异丙酚用量。结果:Ⅱ -Ⅳ组意识消失和BIS50时异丙酚用量与Ⅰ组比较显著性减少,药物起效时间缩短 ;意识消失时Ⅳ组异丙酚用量与Ⅱ、Ⅲ组比较有显著性差异 ;BIS50时Ⅱ -Ⅳ组之间异丙酚用量无统计学差异。4组病人意识消失时BIS为[81.6±10.5(66～90)] ,无差异性。4组病人在意识消失、BIS50、插管时、插管后2min各时段BP、HR、HRV无显著性差异。结论:以意识作为观察指标 ,咪唑安定与异丙酚联合诱导的协同作用随咪唑安定剂量的增加而加强,但以BIS50为观察指标 ,两药的协同作用不呈剂量依赖性。
Objective: To compare the dose relations of midazolam and propofol during co-induction. Is there any difference between taken consciousness or bispectral index (BIS) as a end point. Methods: Forty ASAⅠ-Ⅱ patients were randomly divided into 4 groups. GroupⅠusing Normal Saline (NS) as control; GroupⅡ using midazolam 0.02mg/kg; Group Ⅲ using midazolam 0.04mg/kg; Group Ⅳ using midazolam 0.06mg/kg. One min after given NS or midazolam, propofol were infused at a rate of 1200mg/h. The doses of propofol required for loss of consciousness and BIS 50 were recorded. Results: The dose of propofol required for loss of consciousness and BIS 50 were statistically significantly lower in group Ⅱ-Ⅳ than in group Ⅰ.Dose to loss of consciousness in group Ⅳ was lower than that in group Ⅱ and Ⅲ.However, Dose required for BIS 50 there were no significant differences among group Ⅱ-Ⅳ.When patients lose consciousness, the BIS was [81.6±10.5(66～90)]in the four groups, no significant differences among the groups. There were no significant differences in the respect of BP?HR?HRV at the time of loss of consciousness?BIS 50 ?intubation and 2 min after intubation. Conclusion: Adapted to achieve loss of consciousness as a criteria, the synergistic effect of co-induction with midazolam and propofol with increasing midazolam dosages; but adapted to achieve BIS50, There was no such phenomenon, probably because of individual of EEG.
出处
《天津医科大学学报》
2003年第2期264-266,共3页
Journal of Tianjin Medical University
