咪达唑仑与丙泊酚靶控输注对硬膜外麻醉患者内隐记忆的影响

目的探讨硬膜外麻醉辅以持续靶控输注咪达唑仑和丙泊酚消除内隐记忆的作用。方法在硬膜外麻醉下择期下腹部手术的患者60例,ASAⅠ~Ⅱ级。随机分为2组,每组30例,予以咪达唑仑（M组）和丙泊酚（B组）持续靶控输注镇静。分别于入室后麻醉前（T1）、静脉给予镇静药后30 min（T2）、手术结束前15 min（T3）、患者出手术室时（T4）4个时间点记录镇静效果评分（OAA/S）和听觉诱发电位指数（AAI）值。采用加工分离测试方法（PDP）测试2组患者的外显记忆和内隐记忆。结果 2组患者生命体征均平稳。与给药前比较2组患者AAI值OAA/S评分均显著下降（P〈0.05）。2组患者外显记忆均消失。M组患者术中内隐记忆消失,B组患者术中仍有内隐记忆残留。结论硬膜外麻醉辅以咪达唑仑靶控输注能消除患者的内隐记忆。

Effects of target-controlled Infusion of midazolam or propofol on implicit memory in patients undergoing epidural anesthesia

Objective To compare the effects of the target-controlled infusion（TCI） between midazolam and propofol sedation on implicit memory in patients undergoing epidural anesthesia.Methods Sixty ASAⅠ~Ⅱpatients undergoing elective surgery under epidural anesthesia were randomly divided into two groups： midazolam group（group M,n=30） and propofol group（group B,n=30）,the patients received TCI of midazolam or propofol respectively.The OAA/S AAI was monitored and recorded before anesthesia（T1）,30 min after induction of sedation（T2）,15 min before ended operation（T3） and at the time of leaved operation room（T4）.During operation,implicit memory and explicit memory of the patients were estimated by process dissociation procedure（PDP）.Results During operation,the scores of OAA/S AAI in all the patients were significantly lower than those before anesthesia（P0.05）.The introperative explicit memory was lost in all patients,and implicit memory was spared in group B,however,which is was lost in group M.Conclusion Both explicit and implicit memory are lost during sedation with TCI of midazolam under epidural anesthesia.