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[咪达唑仑诱导是否会降低麻醉期间的应激反应?]

[Does induction with midazolam decrease stress response during anesthesia?].

作者信息

Nishiyama T, Hirasaki A, Odaka Y, Saito M, Seto K

机构信息

Department of Anesthesiology, Kagawa Prefectural Central Hospital, Takamatsu.

出版信息

Masui. 1990 May;39(5):613-8.

PMID:2200896
Abstract

The effects of midazolam on stress response during surgery compared with thiamylal were studied. Twelve patients were divided into 2 groups at random; midazolam group and thiamylal group. Anesthesia was induced with midazolam 0.2 mg.kg-1 or thiamylal 4 mg.kg-1 in each group, and maintained with O2 2 l.min-1, N2O 4 l.min-1 and enflurane. The plasma concentration of catecholamine was measured at preinduction, 10, 30, 60, 120 and 180 minutes after intubation. No significant differences were seen between 2 groups in plasma concentration of catecholamine. In midazolam group, plasma concentration of epinephrine decreased significantly 10 minutes after intubation as compared with preinduction level. The plasma concentration of norepinephrine in midazolam group tended to decrease. In thiamylal group, plasma concentration of norepinephrine tended to increase and increased significantly at 120 and 180 minutes after intubation as compared with preinduction level. These results suggest that induction with midazolam suppresses stress response during anesthetic induction and surgery more intensely than induction with thiamylal.

摘要

研究了咪达唑仑与硫喷妥钠相比在手术期间对应激反应的影响。12例患者随机分为2组,即咪达唑仑组和硫喷妥钠组。每组分别用0.2mg·kg-1咪达唑仑或4mg·kg-1硫喷妥钠诱导麻醉,并用2l·min-1的氧气、4l·min-1的氧化亚氮和恩氟烷维持麻醉。在诱导前、插管后10、30、60、120和180分钟测量血浆儿茶酚胺浓度。两组间血浆儿茶酚胺浓度未见显著差异。在咪达唑仑组,与诱导前水平相比,插管后10分钟肾上腺素血浆浓度显著降低。咪达唑仑组去甲肾上腺素血浆浓度有降低趋势。在硫喷妥钠组,去甲肾上腺素血浆浓度有升高趋势,与诱导前水平相比,插管后120和180分钟显著升高。这些结果表明,与硫喷妥钠诱导相比,咪达唑仑诱导在麻醉诱导和手术期间更强烈地抑制应激反应。

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