Bahar M, Cohen M L, Grinshpon Y, Chanimov M
Department of Anaesthesiology, Assaf Harofeh, Medical Centre, Zerifin, Israel.
Can J Anaesth. 1997 Feb;44(2):208-15. doi: 10.1007/BF03013011.
This study examined in an animal model whether intrathecal midazolam, alone or with fentanyl, can achieve anaesthesia sufficient for laparotomy, comparable to lidocaine. Effects on consciousness and whether anaesthesia was segmental were also examined. The haemodynamic and respiratory changes were compared with those of intrathecal lidocaine or intrathecal fentanyl alone.
Sixty Wistar strain rats, with nylon catheters chronically implanted in the lumbar subarachnoid theca, were divided into six groups. Group 1 (n = 12) received 75 microL intrathecal lidocaine 2%. Group 2 (n = 12) received 75 microL intrathecal midazolam 0.1%, Group 3 (n = 12) received intrathecal 37.5 microL midazolam 0.1%, plus 37.5 microL fentanyl 0.005%. Group 4 (n = 12) received intrathecal 50 microL fentanyl 0.005%. Group 5 (n = 6) received 75 microL midazolam 0.1% iv. Group 6 (n = 6) received halothane 0.6% in oxygen by inhalation.
Both groups that received intrathecal midazolam, alone or combined with fentanyl, developed effective segmental sensory and motor blockade of the hind limbs and abdominal wall, sufficient for a pain-free laparotomy procedure. Neither of these groups, unlike the group that received intrathecal lidocaine, developed a reduction in blood pressure or change in heart rate at the time of maximal sensory or motor blockade, nor were there changes in the arterial blood gases or respiratory rate.
Midazolam, when injected intrathecally, produces reversible, segmental, spinally mediated antinociception, sufficient to provide balanced anaesthesia for abdominal surgery.
本研究在动物模型中检测鞘内注射咪达唑仑单独或与芬太尼联合使用时，是否能达到与利多卡因相当的足以进行剖腹手术的麻醉效果。还检测了其对意识的影响以及麻醉是否具有节段性。将血流动力学和呼吸变化与鞘内注射利多卡因或单独鞘内注射芬太尼的情况进行了比较。
60只Wistar品系大鼠，其腰段蛛网膜下腔长期植入尼龙导管，分为6组。第1组（n = 12）接受鞘内注射2%利多卡因75μL。第2组（n = 12）接受鞘内注射0.1%咪达唑仑75μL，第3组（n = 12）接受鞘内注射0.1%咪达唑仑37.5μL加0.005%芬太尼37.5μL。第4组（n = 12）接受鞘内注射0.005%芬太尼50μL。第5组（n = 6）静脉注射0.1%咪达唑仑75μL。第6组（n = 6）通过吸入接受0.6%氟烷。
接受鞘内注射咪达唑仑单独或与芬太尼联合使用的两组均产生了有效的后肢和腹壁节段性感觉和运动阻滞，足以进行无痛剖腹手术。与接受鞘内注射利多卡因的组不同，这两组在最大感觉或运动阻滞时均未出现血压下降或心率变化，动脉血气或呼吸频率也无变化。
鞘内注射咪达唑仑可产生可逆的、节段性的、脊髓介导的镇痛作用，足以提供腹部手术的平衡麻醉。
