Ben-David B, Vaida S, Gaitini L
Department of Anesthesia, Herzliya-Haifa (Horev) Medical Center, Israel.
Anesth Analg. 1995 Sep;81(3):525-8. doi: 10.1097/00000539-199509000-00017.
We tested whether a high spinal anesthesia may alter the susceptibility to the soporific effects of sedatives. Twenty ASA grade I and II women undergoing elective abdominal hysterectomy were randomly allocated into two groups. Patients in Group I were given a subarachnoid injection of 12 mg hyperbaric tetracaine and those patients who after 10 min had a sensory level of T4-6 (10 patients) were included in the study. Ten additional patients (Group II) received no spinal injection. Induction of anesthesia was performed on all patients by injecting 1 mg of midazolam intravenously every 30 s until the patient failed to respond to three repeated commands to squeeze the anesthetist's hand. This was considered the induction dose or end-point for the purposes of the study. Patients were then given a neuromuscular blocker, ventilated with oxygen, nitrous oxide, and a volatile anesthetic, tracheally intubated, and maintained under general anesthesia for the remainder of the operation. The dose of midazolam administered to the point of patient failure to respond to command was 7.6 +/- 0.72 mg SEM for Group I and 14.7 +/- 1.16 mg SEM for Group II, (P < 0.0001). These results support the conclusion that patients having a high spinal anesthetic are more sensitive to the sedative effects of midazolam.
我们测试了高位脊髓麻醉是否会改变对镇静剂催眠作用的易感性。20名接受择期腹部子宫切除术的美国麻醉医师协会（ASA）I级和II级女性被随机分为两组。第一组患者接受蛛网膜下腔注射12mg重比重丁卡因，10分钟后感觉平面达到T4 - 6的患者（共10例）纳入研究。另外10例患者（第二组）未接受脊髓注射。所有患者均通过每隔30秒静脉注射1mg咪达唑仑进行麻醉诱导，直至患者对三次重复的握拳指令无反应。就本研究而言，这被视为诱导剂量或终点。然后给患者使用神经肌肉阻滞剂，用氧气、氧化亚氮和挥发性麻醉剂进行通气，气管插管，并在全身麻醉下完成剩余手术。第一组患者对指令无反应时给予的咪达唑仑剂量为7.6±0.72mg标准误，第二组为14.7±1.16mg标准误，（P<0.0001）。这些结果支持以下结论：接受高位脊髓麻醉的患者对咪达唑仑的镇静作用更敏感。
