Lau W, Kovoor P, Ross D L
Cardiology Unit, Westmead Hospital, Australia.
Am J Cardiol. 1993 Jul 15;72(2):177-82. doi: 10.1016/0002-9149(93)90156-7.
Midazolam and fentanyl together produce better sedation, analgesia and amnesia than do either drug alone, but the electrophysiologic effects of the combination are unknown. Twenty patients undergoing electrophysiologic studies for clinical reasons were studied. Blood pressure, heart rate, respiratory rate, oxygen saturation, and standard variables related to atrioventricular and ventriculoatrial conduction, dual pathways, accessory pathway conduction, sinus node function, and the inducibility of tachycardia were examined before and after intravenous injections of midazolam (0.07 +/- 0.03 mg/kg) combined with fentanyl (0.8 +/- 0.4 micrograms/kg). There were no significant changes in the electrophysiologic variables or ease of inducibility of tachycardia. The drugs were well tolerated; they produced minor and clinically unimportant reductions in mean blood pressure (99 +/- 13 to 89 +/- 16 mm Hg; p < 0.001) and respiratory rate (18 +/- 4 to 16 +/- 3 breaths/min; p = 0.05). Excellent sedation was achieved. Major amnesia was reported by 95% of patients. In conclusion, midazolam combined with fentanyl provides safe and effective sedation for electrophysiologic studies without significantly affecting electrophysiologic variables or the inducibility of tachyarrhythmias.
咪达唑仑和芬太尼联合使用比单独使用任何一种药物都能产生更好的镇静、镇痛和遗忘效果，但该联合用药的电生理效应尚不清楚。对20例因临床原因接受电生理检查的患者进行了研究。在静脉注射咪达唑仑（0.07±0.03mg/kg）联合芬太尼（0.8±0.4μg/kg）前后，检测了血压、心率、呼吸频率、血氧饱和度以及与房室和室房传导、双径路、旁路传导、窦房结功能和心动过速诱发性相关的标准变量。电生理变量或心动过速的诱发性均无显著变化。这些药物耐受性良好；它们使平均血压（99±13至89±16mmHg；p<0.001）和呼吸频率（18±4至16±3次/分钟；p=0.05）出现轻微且临床上无重要意义的降低。实现了极佳的镇静效果。95%的患者报告有显著的遗忘效果。总之，咪达唑仑联合芬太尼为电生理检查提供了安全有效的镇静作用，且不显著影响电生理变量或室上性心动过速的诱发性。
