不同途径给予咪达唑仑临床效果比较

目的: 比较静脉、肌肉、滴鼻、舌下四种途径给予咪达唑仑的临床效果。方法: ASA Ⅰ~Ⅱ级择期手术患者40例,按不同给药途径随机分成静脉组(V组)、肌肉组(M组)、鼻腔内滴注组(N组)、舌下含服组(S组)。各组依不同途径给予咪达唑仑,观察镇静(OAA/S)程度、BIS指数、VAS评分及记忆情况。结果: 镇静(OAA/S)程度:各组达到3级满意率为V、M组70%,N、S组30%。BIS值:V、M、N、S组分别在用药后5 min、25 min、35 min、35 min逐渐下降,BIS值分别维持在84.3±2.17、89.9±1.23、91.1±0.84、91.3±0.61水平。VA S评分:V、M、N组在用药后均低于治疗前(P<0.05~P<0.01)。遗忘情况:V、M、N、S组产生完全遗忘的百分率间差异有显著性(P<0.005)。结论: 四种途径给予咪达唑仑50 μg/kg,V、M组产生的临床效果优于N、S组。

Comparison of the clinical effects of midazolam through different ways of administration

Objective: To study the effect of midazolam through different ways of administration.Methods: Forty ASA Ⅰ to Ⅱ patients scheduled for elective surgery were enrolled in this study.They were randomly divided into four groups with 10 cases in each group.They were intravenous group(V group),intramuscular group(M group),intranasal group(N group) and subligual group(S group).Each group was given midazolam 50 μg/kg for premedication by different ways of administration.The depth of sedation was monitored by BIS and modified by OAA/S sedation score,VAS score and amnesia.Results: The OAA/S score:70% of the patients in two groups(V,M) became unconscious.However,only 30% of the patients in the other groups(N,S) became unconscious.The BIS index decreased to 84.3±2.17 in V group,89.9±1.23 in M group,91.1±0.84 in N group and 91.3±0.61 in S group.The BIS index in group(V,M,N,S) decreased slightly 5 min,25 min,35 min and 35 min after administration.There were significant changes in the VAS score after giving premedication in V,M and N group(P<0.05 to P<0.01).The percentage of amnesia changed significant(P<0.01).Conclusions: The effects of sedation and amnesia of midazolam administered in a dose of 50 μg/kg are better in V and M groups than in N and S groups.