Hong J-Y, Lee I H, Shin S K, Park E Y, Ban S Y, Cho J E, Kil H K
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Severance Hospital, Yonsei University College of Medicine, Seodaemun-Gu, Seoul, Korea.
Acta Anaesthesiol Scand. 2008 Nov;52(10):1411-4. doi: 10.1111/j.1399-6576.2008.01727.x.
This prospective, randomized, double-blind study aimed to determine whether caudal midazolam combined with ropivacaine affects anesthetic requirements, recovery profiles, and post-operative analgesia compared with ropivacaine alone in pediatric day-case hernioplasty.
Sixty boys (2-5 years old) received caudal injections of 0.2% ropivacaine 1 ml/kg and epinephrine 1 : 200,000 with (RM group) or without (R group) 50 microg/kg of midazolam under sevoflurane anesthesia. The sevoflurane requirement was determined by adjusting to a bispectral index score=50.
Concentrations of end-tidal sevoflurane (ETsevo%) after induction were similar in both groups. After caudal block, ETsevo% before and after surgical stimuli did not show significant intra- or intergroup differences. Recovery characteristics, including post-operative sedations, were similar in both groups. Post-operative pain scores were significantly lower in the RM group than the R group.
Caudal midazolam (50 microg/kg) added to 2% ropivacaine did not influence sevoflurane requirement or recovery but improved post-operative analgesia compared with ropivacaine alone in pediatric day-case hernioplasty.
这项前瞻性、随机、双盲研究旨在确定在小儿日间疝修补术中，与单独使用罗哌卡因相比，骶管注射咪达唑仑联合罗哌卡因是否会影响麻醉需求、恢复情况及术后镇痛效果。
60名2至5岁男孩在七氟醚麻醉下接受骶管注射，其中罗哌卡因组（R组）注射0.2%罗哌卡因1 ml/kg及肾上腺素1:200,000，罗哌卡因 - 咪达唑仑组（RM组）在此基础上额外注射50μg/kg咪达唑仑。通过调整使脑电双频指数评分=50来确定七氟醚需求量。
诱导后两组的呼气末七氟醚浓度（ETsevo%）相似。骶管阻滞完成后，手术刺激前后的ETsevo%在组内及组间均无显著差异。两组的恢复特征，包括术后镇静情况，相似。RM组术后疼痛评分显著低于R组。
在小儿日间疝修补术中，与单独使用罗哌卡因相比，2%罗哌卡因中添加骶管注射咪达唑仑（50μg/kg）不影响七氟醚需求或恢复情况，但可改善术后镇痛效果。
