Broscheit Jens, Kranke Peter
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin im Klinikum der Bayerischen Julius-Maximilians-Universität Würzburg.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2008 Feb;43(2):134-43. doi: 10.1055/s-2008-1060547.
Prior to an operation, patients experience a high degree of stress and internal tension. Preoperative drug administration (premedication) is intended to reduce these stresses through anxiolytic and sedative effects. On account of their good anxiolytic actions, there excellent tolerability and only few side effects benzodiazepines are most frequently used for this purpose. To support the induction and continuation of sleep, premedication is usually initiated in the evening before operation with the administration of a benzodiazepine with middle- or long-term activity. The standard drug for the day of operation is the short-acting benzodiazepine midazolam, under the action of which the patient may be transferred to the operation room in a drowsy and calm state. The onset of action of drugs applied as preoperative medication is delayed. Thus, it is of major importance that the premedication be administered at the appropriate time point so that the patient really is shielded fro preoperative stress at the time of the drug's optimal effect. Although midazolam is not the ideal substance for all situations where an anxiolytic premedication is needed, with the exception of a few special indications, no decisive advantages over other drugs have been demonstrated in comparative trials.
手术前，患者会经历高度的压力和内心紧张。术前给药（术前用药）旨在通过抗焦虑和镇静作用减轻这些压力。由于苯二氮䓬类药物具有良好的抗焦虑作用、出色的耐受性且副作用极少，因此最常用于此目的。为了辅助诱导和持续睡眠，术前用药通常在手术前一晚开始，给予具有中效或长效活性的苯二氮䓬类药物。手术当天的标准药物是短效苯二氮䓬类药物咪达唑仑，在其作用下，患者可在昏昏欲睡且平静的状态下被送往手术室。用作术前用药的药物起效延迟。因此，至关重要的是在适当的时间点给予术前用药，以便在药物达到最佳效果时患者真正免受术前压力的影响。尽管咪达唑仑并非在所有需要抗焦虑术前用药的情况下都是理想药物，但除了少数特殊适应症外，在比较试验中并未显示出其相对于其他药物有决定性优势。
