Brunner M D, Nel M R, Fernandes R, Thornton C, Newton D E F
Department of Anaesthetics and Intensive Care, Division of Surgery, Anaesthetics and Intensive Care, Faculty of Medicine, Imperial College, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK.
Br J Anaesth. 2002 Aug;89(2):325-7. doi: 10.1093/bja/aef190.
In clinical use, midazolam reduces the dose requirement for propofol. We studied the effect of midazolam given before anaesthesia on the amount of propofol needed and the time taken, to achieve loss of consciousness (LOC) in 20 patients.
We compared the auditory evoked responses (AER) in these patients with those in a group of 20 patients who were not given midazolam.
LOC, as defined by a loss of response to verbal command and eyelash reflex, occurred after 113 (95% CI, 99-131) s in the control group and 75 (56-101) s in the midazolam group (P < 0.05). In the control group 2.3 (2.0-2.6) mg kg-1 propofol caused LOC compared with 1.3 (1.1-1.5) mg kg-1 in the group pretreated with midazolam (P < 0.001). Pa amplitude decreased by 60% in the control group and by 54% in the midazolam group while Nb latency increased by 24% in the control group and by 32% in the midazolam group following LOC. These differences were not significant.
We confirmed that coinduction of anaesthesia with midazolam and propofol reduces the requirement of propofol. We also demonstrated that the AER reflects anaesthetic depth rather than plasma concentrations of anaesthetic drugs.
在临床应用中，咪达唑仑可降低丙泊酚的剂量需求。我们研究了麻醉前给予咪达唑仑对20例患者达到意识消失（LOC）所需丙泊酚的量及所需时间的影响。
我们将这些患者的听觉诱发电位（AER）与未给予咪达唑仑的20例患者的听觉诱发电位进行了比较。
以对言语指令和睫毛反射无反应定义的LOC，在对照组中于113（95%可信区间，99 - 131）秒后出现，在咪达唑仑组中于75（56 - 101）秒后出现（P < 0.05）。对照组中2.3（2.0 - 2.6）mg·kg⁻¹丙泊酚导致LOC，而咪达唑仑预处理组为1.3（1.1 - 1.5）mg·kg⁻¹（P < 0.001）。LOC后，对照组Pa波幅下降60%，咪达唑仑组下降54%；对照组Nb潜伏期增加24%，咪达唑仑组增加32%。这些差异无统计学意义。
我们证实了咪达唑仑与丙泊酚联合诱导麻醉可降低丙泊酚的需求量。我们还证明了听觉诱发电位反映的是麻醉深度而非麻醉药物的血浆浓度。
