Stevanović Predrag
Klinicko-bolnicki centar Dr Dragisa Misović-Dedinje, Beograd.
Med Pregl. 2006 Jan-Feb;59(1-2):89-94. doi: 10.2298/mpns0602089s.
Three benzodiazepines are available for IV injection and are commonly used in anesthesia practice: diazepam, lorazepam, and midazolam. The last is the most frequently used in anaesthesia practice. Benzodiazepines induce amnesia and sedation secondary to potentiation of the inhibitory neurotransmitter gamma amino-butyric acid (GABA). Although sleep inducing doses of midazolam (0,2-0,4 mg/kg) may produce unconsciousness in one to three minutes it is commonly used for sedation and to ensure amnesia and premedication. The effects of midazolam on the cardiovascular system are minimal. Mild decreases in blood pressure and heart rate are indicative of its sedative effect. There have been reports of respiratory depression with diazepam, however this response is dose dependent and can be marked if concomitant doses of narcotics are used. Because of its potential for depressing respiration, especially if given with narcotics, the respiratory response of these patients needs to be monitored Intravenous midazolam should be titrated to effect and the benzodiazepine antagonist flumazenil should be immediately available.
有三种苯二氮䓬类药物可供静脉注射，常用于麻醉实践：地西泮、劳拉西泮和咪达唑仑。最后一种是麻醉实践中最常用的。苯二氮䓬类药物通过增强抑制性神经递质γ-氨基丁酸（GABA）来诱导失忆和镇静。虽然诱导睡眠剂量的咪达唑仑（0.2 - 0.4毫克/千克）可能在1至3分钟内导致昏迷，但它通常用于镇静以及确保失忆和术前用药。咪达唑仑对心血管系统的影响极小。血压和心率轻度下降表明其镇静作用。有报道称地西泮会导致呼吸抑制，然而这种反应是剂量依赖性的，如果同时使用麻醉剂，这种反应可能会很明显。由于其有抑制呼吸的可能性，尤其是与麻醉剂合用时，需要监测这些患者的呼吸反应。静脉注射咪达唑仑应根据效果进行滴定，并且应随时准备好苯二氮䓬类拮抗剂氟马西尼。
