右美托咪定复合小剂量咪唑安定在慢诱导麻醉中对镇静程度的影响

目的比较右美托咪定(DEX)复合小剂量咪唑安定与单纯咪唑安定(MDZ)在慢诱导气管插管时对镇静程度的影响。方法 40例择期行气管插管全麻手术患者随机分为右美托咪定复合小剂量咪唑安定组(DEX-MDZ)和单用咪唑安定组(MDZ),每组20例。MDZ组静脉注射MDZ 0.05 mg/kg,增加量0.05 mg/kg,至警觉/镇静(OAA/S)评分2～4分;MDZ-DEX组静脉注射MDZ 0.02 mg/kg,然后于10 min内静注DEX负荷量1μg/kg,再持续泵注0.1μg/(kg.h)逐渐增量至0.7μg/(kg.h),直至镇静评分2～4分。记录重要时间点患者的血压(BP)、心率(HR)、OAA/S评分及反应;记录术后患者对慢诱导气管插管过程的记忆程度及满意度。结果两组患者BP、HR比较差异无统计学意义;DEX-MDZ患者在慢诱导气管插管期间较MDZ组更安静更配合,不良反应少;DEX-MDZ组患者慢诱导气管插管更舒适。结论右美托咪定复合小剂量咪唑安定较单用咪唑安定更适合于慢诱导气管插管。

Effects of dexmedetomidine combined with low-dose of midazolam for sedation on slow induction of anesthesia

Objective To compare the efficacy of dexmedtomidine combined with low-dose of midazolam and midazolam only for sedation during slow induction of anesthesia.Methods 40 patients scheduled for nonemergency surgery with slow induction of anesthesia were randomized into two groups.MDZ group received midazlolam 0.05 mg/kg,iv.with additional doses to achieve OAA/S 2~4;DEX-MDZ group received midazolam 0.02 mg/kg followed by dexmedetomidine 1 μg/kg,then an infusion of dexmedetomidine 0.1 μg/(kg · h) and pumped to 0.7 μg/(kg · h)to achieve OAA/S 2~4.The BP,HR,OAA/S score and reaction at important time points were recorded;The memory and satisfactory degree of slow induction of anesthesia were also recorded.Results There was no significant difference in BP and HR between the two groups.Patients in DEX-MDZ group were calmed and operated more significantly during the procedure with fewer adverse reactions than those of MDZ group.The DEX-MDZ group was more satisfactory in slow induction of anesthesia than MDZ group(P<0.001).Conclusion Dexmedetomidine combined with low dose of midazolam is more effective than midazolam only for sedation during slow induction of anesthesia.