静脉注射咪唑安定对SNAP指数的影响

目的观察静脉注射咪唑安定对SNAP指数的影响。方法选择10例成年经蝶垂体手术后患者。所有患者均主诉入睡困难,按0.1mg/kg的剂量给予咪唑安定静脉注射。分别于给药前、给药后1、5、15、30、45、60、90、120和180min监测并记录SNAP指数、Ramsay量表和Richmond躁动镇静量表(RASS)评分。比较各时间点SNAP指数的差异,进行SNAP指数与Ramsay和RASS评分的相关性分析。结果静脉注射咪唑安定后,SNAP指数逐渐降低,于给药后30min降低至最低水平。随时间延长,SNAP指数逐渐恢复至给药前基础值。给药后5min至90min的SNAP指数明显低于给药前基础水平(P<0.05)。SNAP指数与Ramsay和RASS评分之间具有显著相关性,Spearman相关系数分别为-0.776和0.741(P<0.05)。结论SNAP指数与临床常用主观镇静评分之间相关性良好,SNAP指数能反映患者应用咪唑安定后镇静深度的变化规律。

Effect of Intravenous Injection of Midazolam on SNAP Index

Objective To determine the effect of intravenous injection of midazolam on SNAP index.Methods Ten post transsphenoidal hypophysectomy patients were enrolled in this study. All patients complained of sleeping difficult, midazolam was injected intravenously with a single bolus dose of 0.1 mg/kg. The SNAP index, Ramsay scale and Richmond Agitation and Sedation Scale(RASS) were monitored and documented before medication, and 1, 5, 15, 30, 45, 60, 90, 120 and 180 after medication. The SNAP index was compared at different time points, and was found to be correlated with the Ramsay scale or RASS.Results The baseline SNAP index was 89±6. After intravenous injection of midazolam, the SNAP index declined gradually and reached the lowest level(66±10) at 30 min after medication. After that, It rose gradually to the baseline level. The SNAP indices at 5 min to 90 min after medication were lower than the baseline level significantly(P<0.05). The SNAP index correlated significantly with the Ramsay scale and RASS, with respective Spearman correlation coefficient of-0.776 and 0.741(P<0.05).Conclusion The results of the present study indicats that the SNAP index correlates well the subjective evaluation and it might be a feasible method to monitor the depth of sedation after intravenous injection of midazolam.