Kertész A, Falkay G, Boros M
Acta Med Hung. 1985;42(3-4):145-52.
The effects of anaesthesia inducing benzodiazepines (diazepam, flunitrazepam, midazolam) on serum cortisol level, blood pressure and pulse rate were examined in patients undergoing elective hysterectomy. Diurnal variation of serum cortisol was established two days before operation. Either form of benzodiazepine provided good suppression of the cortisol response to stress during anaesthesia and surgery. The endocrine response to surgical stress was more pronounced at end of the operation in all three groups. Considering the relative changes of cortisol compared to the pre-operative values the smallest differences were seen in the group receiving midazolam. At 6 p.m. on the day of operation the cortisol level decreased in the flunitrazepam and midazolam groups. Especially in the patients who received midazolam at 6 a.m. on the following day the values did not differ from those observed in the control group. On the basis of these examinations it would appear that to prevent adverse stress-induced effects there is a slight advantage in using midazolam for induction of anaesthesia.
在接受择期子宫切除术的患者中，研究了麻醉诱导用苯二氮䓬类药物（地西泮、氟硝西泮、咪达唑仑）对血清皮质醇水平、血压和脉搏率的影响。在手术前两天确定血清皮质醇的昼夜变化。两种苯二氮䓬类药物在麻醉和手术期间均能很好地抑制皮质醇对应激的反应。三组患者在手术结束时对手术应激的内分泌反应更为明显。与术前值相比，考虑皮质醇的相对变化，咪达唑仑组的差异最小。手术当天下午6点，氟硝西泮组和咪达唑仑组的皮质醇水平下降。特别是在次日上午6点接受咪达唑仑治疗的患者中，其值与对照组观察到的值无差异。基于这些检查结果，似乎为防止应激引起的不良影响，使用咪达唑仑诱导麻醉略有优势。
