Tassonyi E, Fuchs T, Forster A
Département d'anesthésiologie, Hôpital cantonal universitaire, Genève.
Agressologie. 1991;32(8-9 Spec No):402-4.
For the induction of anesthesia in neurosurgical patients, the choice between thiopental and midazolam cannot be done on the basis of their respective cardiovascular, respiratory or cerebral effects, since they are similar. Among the advantages of midazolam are the absence of histamine release and excitatory effects. On the contrary the onset and the duration of action as well as the intensity of sedation are less predictable with midazolam when compared to thiopental. Therefore thiopental remains the first drug of choice in this clinical setting. For preoperative sedation in neurosurgical patients, the use of benzodiazepines should be limited, since they can induce respiratory depression mainly in patients with cranial trauma or with chronic obstructive pulmonary disease. The preoperative administration of a benzodiazepine in neurosurgical patients who are under chronic treatment should be decided individually, according to the level of the conscience of the patient and on the half life of the drug.
对于神经外科手术患者的麻醉诱导，硫喷妥钠和咪达唑仑之间的选择不能基于它们各自对心血管、呼吸或大脑的影响，因为这些影响相似。咪达唑仑的优点包括不释放组胺和无兴奋作用。相反，与硫喷妥钠相比，咪达唑仑的起效时间、作用持续时间以及镇静强度更难预测。因此，在这种临床情况下，硫喷妥钠仍是首选药物。对于神经外科手术患者的术前镇静，苯二氮䓬类药物的使用应受到限制，因为它们主要可在颅脑外伤患者或慢性阻塞性肺疾病患者中诱发呼吸抑制。对于正在接受长期治疗的神经外科手术患者，术前苯二氮䓬类药物的使用应根据患者的意识水平和药物半衰期个体化决定。
