咪达唑仑和丙泊酚用于全身麻醉效果的比较

目的观察比较咪达唑仑和丙泊酚单独或联合用药对全麻诱导及维持的效果、麻醉恢复特性和不良反应的影响。方法选择90例全麻手术病人,随机分为3组。A组:麻醉诱导:咪达唑仑0·2mg·kg-1,麻醉维持:咪达唑仑0·15mg·kg-1·h-1;B组:麻醉诱导:丙泊酚1~2mg·kg-1,麻醉维持:丙泊酚2~4mg·kg-1·h-1;C组:麻醉诱导:咪达唑仑0·1mg·kg-1和丙泊酚0·5mg·kg-1,麻醉维持:咪达唑仑0·1mg·kg-1·h-1和丙泊酚1~2mg·kg-1·h-1。各组病例均附加静注芬太尼1~3μg·kg-1及同时吸入异氟醚1%~1·5%,并用适量维库溴铵维持肌肉松弛,行机械通气。结果比较各组不同时相与麻醉前SBP、DBP、HR、SpO2的变化显示,C组SBP、DBP在插管后及拔管前后较麻醉前的变化差异无统计学意义(P>0·05),A组和B组与麻醉前比较差异均存在统计学意义(P<0·05)。从术毕到病人睁眼的苏醒时间,A组为(34·44±12·35)min,B组为(6·56±5·74)min,C组为(14·64±9·50)min,3组间差异有统计学意义(F=62·21,P=0·000)。苏醒期出现躁动者A组为20%(6/30),B组为30%(9/30),C组为16·67%(5/30)。结论咪达唑仑和丙泊酚联合用于麻醉诱导和维持,可以发挥各自的特点与优势,使麻醉诱导及苏醒恢复期更加平稳,各种不良反应更趋缓和。

A Clinical Study on General Anesthesia with Midazolam and Propofol

Objective To investigate the profile of anesthesia with midazolam and propofol.Methods 90 patients were randomly allocated into three groups. In group A, patients were induced with midazolam 0.2 mg·kg^-1 and maintained with 0.15 mg·kg^-1 ·h^-1. In group B, propofol 1～2 mg·kg^-1 was used for induction, and 2～4 mg·kg^-1 ·h^-1 for maintenance. In group C, midazolam 0.1 mg·kg^-1 and propofol 0.5¹ mg·kg^-1 were used for induction, and midazolam 0.1 mg·kg^-1 ·h^-1 and propofol 1～2 mg·kg^-1 ·h^-1 were infused for maintenance. Fentanyl 1～3 μg·kg^-1 and vecuronium were injected intravenously and 1%～1.5% isoflurane was inhaled as needed. SBP, DBP, HR and SpO₂ were monitored continuously during anesthesia. The recovery was observed.Results SBP, DBP, HR, SpO₂ of every stage were compared with those of preanesthesia in each group, it was found that SBP, DBP in group C had no difference (P>0.05), and had significant difference in group A and B (P<0.05). The patients awakened (34.44±12.35) min after operation with 6 anxiety, 11 nausea, 9 vomiting and no case dream during the first 24 h after surgery in group A, The patients awakened fast (6.56±5.74) min with 9 anxiety, 7 dream, 13 nausea, 11 vomiting and 16 pain during the first 24 h after the operations in group B, The patients opened their eyes (14.64±9.50) min after surgery with 5 anxiety, 2 dream, 8 nausea, 4 vomiting and 10 pain during the first 24 h after operations in group C.Conclusion The combination of midazolam and propofol is a suitable method for general anesthesia.