Rodrigo C, Chow K C
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Pokfulam.
J Oral Maxillofac Surg. 1995 Apr;53(4):406-10; discussion 410-1. doi: 10.1016/0278-2391(95)90712-2.
The maximum effect of midazolam injected intravenously occurs in about 3 minutes. Patient-controlled sedation carried out with 1-mg increments of midazolam at 3-minute intervals provides comparable conditions to that of doctor-controlled sedation carried out with 1-mg increments at 1-minute intervals, except for the longer duration taken for the patients to achieve satisfactory sedation prior to surgery. The purpose of this study was to find out how safe it would be to shorten the interval of increments of midazolam to 1 minute in patient-controlled sedation.
In a randomized crossover study, 26 patients undergoing bilateral lower third molar surgery at two visits had patient-controlled sedation with 1 mg midazolam increments at 1-minute or 3-minute intervals at one visit and the alternative at the other visit.
The time taken for patients to achieve a degree of sedation that they thought was sufficient to tolerate the surgery was significantly longer when the increment interval was 3 minutes (t = -4.8; P < .05). Both techniques provided good operating conditions, stable vital signs, mild to moderate sedation, without loss of verbal contact.
A significant majority preferred the sedation technique with 1-minute increment intervals (chi 2 = 4.6; P < .05).
静脉注射咪达唑仑的最大效果在约3分钟内出现。以1毫克的增量、每隔3分钟进行一次的患者自控镇静，与以1毫克的增量、每隔1分钟进行一次的医生控制镇静相比，能提供相当的条件，只是患者在手术前达到满意镇静所需的时间更长。本研究的目的是弄清楚在患者自控镇静中，将咪达唑仑增量的间隔缩短至1分钟有多安全。
在一项随机交叉研究中，26例接受双侧下颌第三磨牙手术的患者分两次就诊，一次就诊时以1分钟的间隔、每次增加1毫克咪达唑仑进行患者自控镇静，另一次就诊时则以3分钟的间隔进行。
当增量间隔为3分钟时，患者达到他们认为足以耐受手术的镇静程度所需的时间明显更长（t = -4.8；P <.05）。两种技术均提供了良好的手术条件、稳定的生命体征、轻度至中度的镇静，且未丧失言语交流能力。
绝大多数人更喜欢增量间隔为1分钟的镇静技术（χ2 = 4.6；P <.05）。
