From the Department of Anesthesiology, Faculty of Medicine, Trakya University, Edirne, Turkey.
From the Department of Anesthesiology and Reanimation, Pendik Bolge Hospital, Istanbul, Turkey.
Ann Saudi Med. 2020 May-Jun;40(3):175-182. doi: 10.5144/0256-4947.2020.175. Epub 2020 Jun 4.
There is limited data on the use of intravenous continuous infusion (CI) versus intravenous intermittent bolus (IB) doses of midazolam for conscious sedation in patients with chronic renal failure. Unexpected adverse events can occur in chronic renal failure patients undergoing short procedures.
Investigate and compare the sedoanalgesic and adverse effects of intravenous continuous infusion (CI) use of midazolam with intravenous intermittent bolus (IB) doses of midazolam while using intravenous remifentanil as a rescue medication, and assess patient and surgeon satisfaction.
Prospective, randomized, single-blind controlled study.
Two tertiary care hospitals.
Study included patients aged 43-81 years with a diagnosis of chronic renal failure who were referred for an arteriovenous fistula procedure with modified anesthesia care between August 2012 and April 2016. The patients were randomized to intravenous CI or IB doses of midazolam. IB doses of remifentanil were used as a rescue medication.
Primary outcomes were amounts of midazolam and remifentanil medications during the operation, the amount of remifentanil as a rescue medication, and the satisfaction of patient and surgeon.
116 assessed for eligibility; 99 randomized to CI (n=50) or IB doses (n=49 of midazolam).
The total dose of midazolam by CI was greater than with midazolam by IB (=.002). The total dose of remifentanil was higher with IB doses of midazolam in comparison to CI of midazolam (=.001). The groups were similar in sedation and pain control, duration of procedure, recovery time, patient satisfaction and adverse events; surgeon satisfaction was greater with CI versus IB (=.035).
Intravenous CI midazolam during MAC provides better surgeon satisfaction then IB midazolam and can be used safely for arteriovenous fistula procedures.
Two different surgeon groups.
None.
慢性肾衰竭患者接受镇静时，咪达唑仑静脉持续输注（CI）与静脉间歇性推注（IB）剂量的数据有限。在接受短程手术的慢性肾衰竭患者中可能会出现意外的不良事件。
研究并比较在使用静脉注射瑞芬太尼作为解救药物时，咪达唑仑静脉持续输注（CI）与静脉间歇性推注（IB）剂量的镇静镇痛效果及不良反应，并评估患者和术者满意度。
前瞻性、随机、单盲对照研究。
两家三级保健医院。
本研究纳入 2012 年 8 月至 2016 年 4 月期间因改良麻醉护理行动静脉瘘术的年龄在 43-81 岁的慢性肾衰竭诊断患者。患者随机分为咪达唑仑静脉 CI 或 IB 剂量组。瑞芬太尼 IB 剂量作为解救药物。
主要结局指标为手术期间咪达唑仑和瑞芬太尼药物的用量、瑞芬太尼作为解救药物的用量以及患者和术者的满意度。
116 例患者进行了入选评估，99 例随机分为 CI（n=50）或咪达唑仑 IB 剂量组（n=49）。
CI 组咪达唑仑的总剂量大于 IB 剂量组（=0.002）。与咪达唑仑 CI 组相比，咪达唑仑 IB 剂量组的瑞芬太尼总剂量更高（=0.001）。两组在镇静和疼痛控制、手术持续时间、恢复时间、患者满意度和不良反应方面相似；与 IB 剂量组相比，CI 组术者满意度更高（=0.035）。
MAC 期间静脉 CI 咪达唑仑较 IB 咪达唑仑提供更好的术者满意度，并且可以安全用于动静脉瘘手术。
两组不同的术者组。
无。
