Nishiyama T, Hirasaki A, Odaka Y, Konishi H, Seto K, Goto I
Department of Anesthesiology, Kagawa Prefectural Central Hospital, Takamatsu.
Masui. 1992 Jan;41(1):49-54.
Optimal dose of epidural midazolam with saline for postoperative pain relief was investigated. Forty three patients for upper abdominal surgery were divided into 5 groups. Each group had either 10 ml saline only (saline group), 10 ml saline + midazolam 0.025 mg.kg-1 (0.025 group), 10 ml saline + midazolam 0.05 mg.kg-1 (0.05 group), 10 ml saline + midazolam 0.075 mg.kg-1 (0.075 group), or 10 ml saline + midazolam 0.1 mg.kg-1 (0.1 group) administered epidurally for complaint of postoperative pain. Blood pressure (BP), heart rate (HR), respiratory rate (RR) and sedation score (SS) were monitored for 120 minutes, and the time interval for next analgesics (TNA) was checked. In each group, BP was unchanged compared with preinjection level. HR changes were less in 0.05 and 0.1 group than in others. RR changes were less in 0.025 and 0.05 group than in others. Optimal SSs were obtained in 0.025 and 0.05 groups. In 0.075 and 0.1 groups, many patients fell into complete sleep (not responded to verbal command). TNA was about 2 hours in 0.025 and 0.05 groups, over 6 hours in 0.075 and 0.1 groups. Complete sleep was the cause of long TNA in 0.075 and 0.1 groups. It was concluded that optimal dose of epidural midazolam with saline 10 ml was 0.05 mg.kg-1 for postoperative pain relief after upper abdominal surgery.
研究了硬膜外注射咪达唑仑与生理盐水混合液用于术后镇痛的最佳剂量。43例上腹部手术患者被分为5组。每组分别硬膜外注射仅10ml生理盐水（生理盐水组）、10ml生理盐水 + 咪达唑仑0.025mg·kg⁻¹（0.025组）、10ml生理盐水 + 咪达唑仑0.05mg·kg⁻¹（0.05组）、10ml生理盐水 + 咪达唑仑0.075mg·kg⁻¹（0.075组）或10ml生理盐水 + 咪达唑仑0.1mg·kg⁻¹（0.1组）以缓解术后疼痛。监测血压（BP）、心率（HR）、呼吸频率（RR）和镇静评分（SS）120分钟，并检查下次使用镇痛药的时间间隔（TNA）。每组中，血压与注射前水平相比无变化。0.05组和0.1组的心率变化小于其他组。0.025组和0.05组的呼吸频率变化小于其他组。0.025组和0.05组获得了最佳镇静评分。在0.075组和0.1组中，许多患者进入完全睡眠状态（对言语指令无反应）。0.025组和0.05组的TNA约为2小时，0.075组和0.1组超过6小时。0.075组和0.1组中TNA延长的原因是完全睡眠。得出结论，对于上腹部手术后的术后疼痛缓解，10ml生理盐水与咪达唑仑混合的最佳硬膜外剂量为0.05mg·kg⁻¹。
