Korttila K, Saarnivaara L, Tarkkanen J, Himberg J J, Hytönen M
Br J Anaesth. 1978 Mar;50(3):281-7. doi: 10.1093/bja/50.3.281.
Diazepam and flunitrazepam were compared as amnesic and sedative adjuncts to local anaesthesia for diagnostic bronchoscopy in 92 patients. After local anaesthesia of the pharynx, larynx and trachea with lignocaine, atropine plus diazepam of flunitrazepam was injected i.v. The co-operation of the patients and the technical circumstances under which the bronchoscopy was performed were good in each group. None of the treatments significantly modified arterial pressure or heart rate. Two hours after the injection, flunitrazepam 0.01 mg kg-1 more frequently caused amnesia for pictures shown to the patients during the first 15 min after injection (failure to recall 42--75%, and for bronchoscopy 67%), than did diazepam 0.125 mg kg-1 (failure to recall 21--67%; bronchoscopy 38%). Double doses of the drugs caused amnesic actions similar to those of flunitrazepam 0.01 mg kg-1. When failure to recall was assessed on the following day, 29% and 5% of the patients remembered bronchoscopy after flunitrazepam 0.01 and 0.02 mg kg-1 respectively; after diazepam 0.125 and 0.25 mg kg-1 the corresponding percentages was 59% and 30% (P less than 0.05% v. fluintrazepam). The ability to stand and walk on a stright line was similar after the smaller doses of both drugs, but after the larger doses recovery was slower after flunitrazepam. Psychomotor performance was still distinctly impaired 2 h after the injection of the larger doses.
对92例患者在诊断性支气管镜检查中，比较了地西泮和氟硝西泮作为局部麻醉辅助用药时的遗忘和镇静作用。用利多卡因、阿托品对咽、喉和气管进行局部麻醉后，静脉注射地西泮或氟硝西泮。每组患者的配合情况以及支气管镜检查的技术条件均良好。各治疗组均未显著改变动脉压或心率。注射后2小时，0.01mg/kg的氟硝西泮比0.125mg/kg的地西泮更常导致患者对注射后最初15分钟内展示的图片失忆（遗忘率42%-75%，支气管镜检查时为67%），地西泮组的遗忘率为21%-67%（支气管镜检查时为38%）。双倍剂量的药物产生的遗忘作用与0.01mg/kg的氟硝西泮相似。当在次日评估遗忘情况时，分别有29%和5%的患者在接受0.01mg/kg和0.02mg/kg氟硝西泮后记得支气管镜检查；接受0.125mg/kg和0.25mg/kg地西泮后，相应的百分比为59%和30%（与氟硝西泮相比，P<0.05）。两种药物较小剂量注射后，患者站立和直线行走的能力相似，但较大剂量注射后，氟硝西泮后的恢复较慢。注射较大剂量药物2小时后，精神运动表现仍明显受损。
