Hamdy N A, Kennedy H J, Nicholl J, Triger D R
Br J Clin Pharmacol. 1986 Dec;22(6):643-7. doi: 10.1111/j.1365-2125.1986.tb02952.x.
A double-blind controlled study comparing the effects of intravenous Diazemuls (0.15 mg kg-1) with midazolam (0.07 mg kg-1) in patients with normal liver function and with cirrhosis and portal hypertension is described. The clinical effect of the two drugs was assessed by serial tests of psychomotor function before and at varying intervals after administration. Using this dosage regime, midazolam caused significantly greater impairment in psychomotor function in both cirrhotic and non cirrhotic subjects, and the time taken for recovery of normal function was also significantly prolonged. Patients with cirrhosis showed a significantly prolonged recovery time following administration of either benzodiazepine compared with the controls. Administration of midazolam in a lower dose might reduce the degree of sedation and shorten the recovery time, but this could also lead to a loss of some of the amnesic effect. Caution is recommended in the administration of benzodiazepines to patients with cirrhosis.
本文描述了一项双盲对照研究，该研究比较了静脉注射地西泮乳剂（0.15毫克/千克）与咪达唑仑（0.07毫克/千克）对肝功能正常、肝硬化及门静脉高压患者的影响。通过给药前及给药后不同时间间隔的系列精神运动功能测试，评估两种药物的临床效果。采用该剂量方案时，咪达唑仑在肝硬化和非肝硬化受试者中均导致精神运动功能明显受损，且恢复正常功能所需时间也显著延长。与对照组相比，肝硬化患者在给予任何一种苯二氮䓬类药物后恢复时间均显著延长。较低剂量的咪达唑仑给药可能会降低镇静程度并缩短恢复时间，但这也可能导致部分遗忘效应丧失。建议对肝硬化患者使用苯二氮䓬类药物时要谨慎。
