摘要
目的评价咪达唑仑对异丙酚-瑞芬太尼全凭静脉麻醉下脊柱矫形术患者术中唤醒试验效果的影响。方法择期行脊柱矫形术患者36例,随机分为异丙酚-瑞芬太尼组（PR组）和咪达唑仑-异丙酚-瑞芬太尼组（MPR组）,每组18例。两组均采用瑞芬太尼、阿曲库铵、异丙酚行麻醉诱导和麻醉维持,MPR组麻醉诱导前即刻静脉注射咪达唑仑0.1 mg/kg,PR组静脉注射生理盐水3 ml。术中行唤醒试验,记录唤醒时间、唤醒期间患者有无烦躁。术后第1天随访,记录患者对唤醒试验及术中其他事件的回忆情况。结果所有患者均成功实施唤醒试验,唤醒期间无烦躁,术后无脊髓损伤的临床表现,且对术中其他事件无回忆。两组唤醒时间差异无统计学意义（P〉0.05）,MPR组患者对唤醒试验回忆发生率低于PR组（P〈0.05）。结论异丙酚-瑞芬太尼全凭静脉麻醉下脊柱矫形术患者麻醉诱导前即刻静脉注射咪达唑仑0.1 mg/kg可以提高术中唤醒试验的效果。
Objective To investigate the effect of midazolam on awareness during intraoperative wake-up test in patients undergoing spinal surgery under propofol-remifentanil anesthesia.Methods Thirty-six ASAⅠorⅡpatients（19 male,17 female）aged 12-30 yr weighing 35-60 kg schedulaed for spinal surgery were randomly allocated to one of 2 groups（n=18 each）：control group and midazolam group.Anesthesia was induced and maintained with propofol,remifentanil and atracurium.The patients in midazolam group received midazolam 0.1 mg/kg iv before induction while in control group normal saline was given instead of midazolam.During the wake-up test,the patients were asked to move their fingers every 30 seconds until they responded.Then they were instructed to wiggle their toes.The duration from interruption of anesthesia to the patients responding to commands was defined as the wake-up onset time and recorded.On the following day the patients were interviewed to ascertain whether they remembered the intraoperative events including pain,voice during the wake-up test.Results The two groups were comparable with respect to demographic data.Only one wake-up test was performed during operation in each patient.No agitation was observed and all patients wiggled their toes as instructed during the wake-up test.No patient developed any neurological deficit after operation and no patient was aware of intraoperative events before and after wake-up test.There was no significant difference in wake-up onset time between the 2 groups.The incidence of awareness during the wake-up test was significantly lower in midazolam group than in control group.Conclusion Midazolam 0.1 mg/kg given iv before induction of anesthesia can decrease the incidence of awareness during the wake-up test in patients undergoing spinal surgery under prepofol- remifentanil anesthesia.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2007年第10期893-895,共3页
Chinese Journal of Anesthesiology
关键词
咪达唑仑
二异丙酚
哌啶类
脊柱疾病
监测
手术中
Midazolam
Propofol
Piperidines
Spinal diseases
Monitoring,intraoperative
