Ulusoy Hulya, Coskun Ilker, Arslan Mehmet
Department of Anesthesiology and Critical Care, Karadeniz Technical University, Faculty of Medicine, TRABZON, Turkey
Umut Hospital, Anesthesiology, ORDU, Turkey.
J Int Med Res. 2016 Jun;44(3):542-56. doi: 10.1177/0300060515600189. Epub 2016 Mar 4.
To evaluate the sedative efficacy and effects on early period cognitive function of premedication in endoscopic retrograde cholangiopancreatography (ERCP).
Forty patients (18-70 years; American Society of Anesthesiology risk category I-III) undergoing elective ERCP were randomized to receive oral premedication with 0.15 mg/kg midazolam or 1 mg/kg tramadol. Cognitive function was determined by mini-mental test (MMT). Target scores for effective sedation were determined as a Bispectral index score of 70-90 and modified Ramsay Sedation Scale score (mRSS) of 2-4.
Global MMT score was not significantly different between treatment groups at 60 min post-ERCP. A significant deterioration in the MMT subcategory of recall was determined in with midazolam versus tramadol. Level of sedation (mRSS) was higher in with midazolam compared with tramadol reaching statistical significance at 30 min after drug administration.
Although more effective sedation was obtained with midazolam in patients undergoing ERCP, there was a dysfunction in memory recall. It was concluded, however, that early cognitive functions were generally preserved with both drugs.
评估内镜逆行胰胆管造影术（ERCP）术前用药的镇静效果及对早期认知功能的影响。
40例择期行ERCP的患者（年龄18 - 70岁；美国麻醉医师协会风险分级I - III级）被随机分为两组，分别口服0.15 mg/kg咪达唑仑或1 mg/kg曲马多进行术前用药。通过简易精神状态检查（MMT）测定认知功能。有效镇静的目标分数确定为脑电双频指数（Bispectral index）评分70 - 90分以及改良拉姆齐镇静评分（mRSS）2 - 4分。
ERCP术后60分钟时，各治疗组间的整体MMT评分无显著差异。与曲马多相比，咪达唑仑组的MMT回忆子类别有显著恶化。与曲马多相比，咪达唑仑组的镇静水平（mRSS）更高，在给药后30分钟达到统计学意义。
尽管咪达唑仑在接受ERCP的患者中能产生更有效的镇静效果，但存在记忆回忆功能障碍。然而，得出的结论是，两种药物一般都能保留早期认知功能。
