Nishiyama T, Furuya C, Hanaoka K
Department of Anesthesiology, Faculty of Medicine, University of Tokyo.
Masui. 1997 Sep;46(9):1172-8.
Midazolam is widely used in anesthesia. This paper shows characteristics of midazolam and how to use midazolam in clinical anesthesia. As a premedication, midazolam should be injected i. m. 15 min before entering an operating room in a dose of 0.04 mg.kg-1 to 0.08 mg.kg-1 according to the patient's age. For anesthesia induction, midazolam should be used together with barbiturate or propofol to take advantage of synergistic effects. Continuous infusion of midazolam in total intravenous anesthesia with fentanyl results in hemodynamic stability and good postoperative analgesia. During spinal or epidural anesthesia, i.v. midazolam of 0.05 mg.kg-1 has anti-anxietic and sedative effects. Midazolam inhibits awakening during cardiopulmonary bypass and it has little cardiodepressant effect. In aged, hepatic damaged or renal damaged patients, the effects of midazolam are slightly increased. Therefore, lower doses may be required in such patients. In conclusion, midazolam is usable in premedication, induction, maintenance in general anesthesia and in sedation in local anesthesia.
咪达唑仑在麻醉中广泛应用。本文阐述了咪达唑仑的特性以及在临床麻醉中如何使用咪达唑仑。作为术前用药，咪达唑仑应在进入手术室前15分钟肌肉注射，根据患者年龄，剂量为0.04mg/kg至0.08mg/kg。用于麻醉诱导时，咪达唑仑应与巴比妥类药物或丙泊酚联合使用，以发挥协同作用。在芬太尼全静脉麻醉中持续输注咪达唑仑可维持血流动力学稳定并产生良好的术后镇痛效果。在脊髓或硬膜外麻醉期间，静脉注射0.05mg/kg的咪达唑仑具有抗焦虑和镇静作用。咪达唑仑可抑制体外循环期间的苏醒，且几乎没有心脏抑制作用。在老年、肝损伤或肾损伤患者中，咪达唑仑的作用略有增强。因此，此类患者可能需要较低剂量。总之，咪达唑仑可用于术前用药、诱导、全身麻醉维持以及局部麻醉中的镇静。
