Glisson S N
J Cardiovasc Pharmacol. 1987 Jan;9(1):45-50.
Midazolam differs from diazepam in that midazolam is water-soluble, more potent and has a shorter elimination half-life (t1/2). To date, it has been used primarily for induction of anesthesia and as an anesthetic supplement. Diazepam has been shown to decrease the catecholamine response to perioperative stress. This study determined the extent to which midazolam influences the physiological and hormonal responses that are evoked by a nitroprusside-induced hypotensive challenge. Plasma levels of epinephrine, norepinephrine (NE), cortisol, and renin activity, as well as hemodynamic performance were measured in dogs anesthetized with enflurane-nitrous oxide-oxygen. Midazolam 0.2 mg/kg i.v. administered prior to a 30% decrease in mean blood pressure statistically attentuates the increase in plasma catecholamines. The cortisol and renin increases that occurred in response to the hypotension were not affected appreciably by midazolam. Hemodynamic changes due to midazolam were minimal, with only a transient 8-10% decrease in mean blood pressure observed. The findings of this study demonstrate that midazolam, like diazepam and fentanyl, can reduce the physiological and hormonal response to hypotensive episodes that occurred during the course of anesthesia and surgery.
咪达唑仑与地西泮不同，在于咪达唑仑是水溶性的，效力更强且消除半衰期（t1/2）更短。迄今为止，它主要用于诱导麻醉和作为麻醉辅助用药。已表明地西泮可降低围手术期应激引起的儿茶酚胺反应。本研究确定了咪达唑仑对硝普钠诱导的低血压刺激所引发的生理和激素反应的影响程度。在用恩氟烷-氧化亚氮-氧气麻醉的犬中测量了血浆肾上腺素、去甲肾上腺素（NE）、皮质醇和肾素活性水平以及血流动力学指标。静脉注射0.2mg/kg咪达唑仑，在平均血压下降30%之前给药，能在统计学上减弱血浆儿茶酚胺的升高。因低血压而发生的皮质醇和肾素升高未受到咪达唑仑明显影响。咪达唑仑引起的血流动力学变化极小，仅观察到平均血压有短暂的8-10%下降。本研究结果表明，咪达唑仑与地西泮和芬太尼一样，可降低麻醉和手术过程中发生的低血压发作所引起的生理和激素反应。
