Bodenham A, Brownlie G, Dixon J S, Park G R
Department of Anaesthesia and Intensive Care, Addenbrooke's Hospital, Cambridge.
Anaesthesia. 1988 May;43(5):376-8. doi: 10.1111/j.1365-2044.1988.tb09016.x.
A 22-year-old male was involved in a road traffic accident and sustained multiple injuries. He received an infusion of midazolam to sedate him during a period of artificial ventilation. His conscious level remained depressed 36 hours after the infusion was discontinued but the sedation was completely reversed with flumazenil. An infusion was started because of the short duration of action of flumazenil, and continued for 8 days. The infusion was stopped seven times during this period and on each occasion except the last, his conscious level deteriorated but returned to normal when flumazenil was administered again. Plasma concentrations of midazolam and alpha-hydroxymidazolam were measured and found to be low during this period. Possible explanations for this finding are discussed.
一名22岁男性遭遇道路交通事故，全身多处受伤。在人工通气期间，他接受了咪达唑仑输注以使其镇静。输注停止36小时后，他的意识水平仍处于抑制状态，但使用氟马西尼后镇静作用完全逆转。由于氟马西尼作用时间短，开始了一次输注，并持续了8天。在此期间，输注停止了7次，除最后一次外，每次停止输注后他的意识水平都恶化，但再次给予氟马西尼后又恢复正常。在此期间测量了咪达唑仑和α-羟基咪达唑仑的血浆浓度，发现浓度较低。文中讨论了这一发现的可能解释。
