咪达唑仑用于上肢创伤病人麻醉前给药的遗忘作用与脑电变化

目的:评价咪达唑仑用于上肢创伤病人行高位硬膜外阻滞的遗忘作用和相应的脑电变化。方法:选择40例单纯上肢创伤病人行高位硬膜外阻滞随机双盲分为四组:咪达唑仑0.15mg/kg和0.10mg/kg,安定0.20mg/kg,生理盐水2ml,麻醉前30分钟肌注,观察用药前后脑电改变,镇静分级对麻醉操作的遗忘率和程度以及术后心理状况。结果:用咪达唑仑后,镇静程度与遗忘效果有显著变化。0.10mg/kg咪达唑仑的遗忘率为70%,其中90%为不全遗忘;0.15mg/kg咪达唑仑可达到100%完全遗忘;咪达唑仑的脑电功率谱变化为δ和β相对功率明显增加,而θ和α相对功率明显下降。结论:肌注咪达唑仑完全可以消除病人对高位硬膜外麻醉穿刺操作过程的不良回忆,并与剂量相关。

Amnesia effects and EEG changes of midazolam on preanesthetic medication of patients with upper limb trauma

Objective: To evaluate the amnesia effects( AE) and corresponding EEG changes of midazolam on the patients with upper limb trauma( ULT) under sublimis epidural block( SEB) . Methods: 40 patients with ULT under SEB were randomly and double- blindly divided into four groups. Midazolam 0. 15mg/ kg was given in group A, midazolam 0. 10mg/ kg in group B, diazepam 0. 20mg/ kg in group C and normal saline 2 ml in group D, injecting intramuscularly 30 minutes before anaesthesia. Premedication and postmedication EEG changes, amnesia degrees of anesthesia procedure of sedative grading and postoperative psychologic status were observed. Results: After giving midazolam, there were signifi?? cant differences in sedative degrees and amnesia effects. Amnesia rate in group B was 70%, of which, 90% of the patients were pero- amnesia; but amnesia rate in group A reached 100%. EEG power spectrum of midazolam was the increasing of relative power of ??and ??, but the decreasing of relative power of ??and ??. Conclusion: Midazolam injecting intramuscularly could relieve the patients from the bad recall during the puncture procedure of SEB,which was related to dose( 0. 10~ 0. 15mg/ kg, IMI, best) , but less dose for the aged.