Liang S W
First Affiliated Hospital, Zhongshan University of Medical Science, Guangzhou.
Zhonghua Wai Ke Za Zhi. 1991 Mar;29(3):161-4, 205.
In this study, the effects of midazolam (M), diazepam (D) and thiopentone (T) on respiratory and cardiovascular systems were compared. The patients were randomly divided into 6 groups, besides minute ventilatory volume (MV), onset of induction and cardiovascular changes were also observed. Induction was performed by a bolus injection of one of the following: midazolam (0.3 mg/kg), diazepam (0.3 mg/kg) or thiopentone (5 mg/kg). Five minutes later, 5 micrograms/kg fentanyl and 1.5-2.0 mg/kg succinylcholine were administered. The results showed that: (1) Inhibitory effect on MV was not prominent and similar after use of midazolam and diazepam but was remarkable after thiopental; (2) As for the onset, midazolam was faster than diazepam but slower than thiopentone; (3) Hemodynamic changes of midazolam, diazepam and thiopentone were similar, however during intubation, cardiovascular response was the least in midazolam, diazepam the intermediate and thiopentone the most significant. We conclude that midazolam is a water-soluble, safe and effective inductive anesthetic with its short eliminated half-life period, and much lesser venous irritation, and it is certainly superior to both diazepam and thiopentone.
本研究比较了咪达唑仑(M)、地西泮(D)和硫喷妥钠(T)对呼吸和心血管系统的影响。患者被随机分为6组,除观察分钟通气量(MV)外,还观察诱导起效时间和心血管变化。诱导通过静脉推注下列药物之一进行:咪达唑仑(0.3mg/kg)、地西泮(0.3mg/kg)或硫喷妥钠(5mg/kg)。5分钟后,给予5μg/kg芬太尼和1.5 - 2.0mg/kg琥珀酰胆碱。结果显示:(1)咪达唑仑和地西泮使用后对MV的抑制作用不显著且相似,但硫喷妥钠使用后显著;(2)在诱导起效方面,咪达唑仑快于地西泮但慢于硫喷妥钠;(3)咪达唑仑、地西泮和硫喷妥钠的血流动力学变化相似,然而在插管期间,咪达唑仑的心血管反应最小,地西泮居中,硫喷妥钠最显著。我们得出结论,咪达唑仑是一种水溶性、安全有效的诱导麻醉剂,其消除半衰期短,静脉刺激性小得多,肯定优于地西泮和硫喷妥钠。