- 期刊
Low Dose Ketamine and Midazolam as Supplements for Spinal Anesthesia
低劑量Ketamine和Midazolam合併使用作爲脊髓麻醉之輔助劑
摘要
背景：合併使用低劑量ketamine和midazolam作爲脊髓麻醉之輔助劑，研究其對於脊髓穿刺刺激之止痛作用與手術中鎮靜之效果。 方法：在做脊髓穿刺前靜脈給予第一組(n=30)Ketamine 0.5mg/kg與midazolam0.05mg/kg，第二組(n=30)0.5mg/kg與midazolam 0.1mg/kg。 結果：動脈收縮壓，舒張壓，心率，動脈血氧飽和度在給藥前後並未有明顯差異。多數病患對於脊髓穿刺刺激有良好的止痛效果。Ketamine與midazolam合併使用誘導産生短時間的無意識現象(第一組4.1分；第二組8.5)；意識恢複(由開給藥到精神定向mental orientation回複)分別是第一組8.8分，第二組15.1。它們也是提供手術中鎮靜效果，第二組的病患明顯在給藥後之30分鐘內有較大的鎮靜作用。所有病患中並無明顯呼吸抑制作用，不自主軀幹運動表現，或是對脊髓穿刺有記憶現象。但是第一組有7位，第二組有4位病患有做夢的副作用表現。 結論：合併使用低劑量Ketamine與midazolam作爲脊髓麻醉的輔助劑在臨床上應該是有幫助的。
並列摘要
Background: Low dose ketamine and midazolam together were used as supplements during spinal anesthesia to provide analgesia for insertion of spinal needle and intraoperative sedation. Methods: Two regimens of drug combination (ketamine 0.5 mg/kg and midazolam 0.05 mg/kg in group I, n=30; ketamine 0.5 mg/kg and midazolam 0.1 mg/kg in group II, n=30) were administered intravenously before proceeding lumbar puncture. Results: Systolic and diastolic arterial blood pressure, heart rate, and arterial oxygen saturation did not change significantly before and after the administration of drugs. Most patients in both groups showed good analgesic response to the lumbar puncture. The medications induced a brief unconsciousness (4.1 min in group I; 8.5 min in group II). The time from drug administration to recovery of mental orientation was 8.8 mm in group I and 15.1 mm in group II. The regimens also provided intraoperative sedation. Patients in group II appeared to be more depressed than group Ⅰ in the first 30 min. None of the patients had significant respiratory disturbance, involuntary movement, or recall to spinal puncture. There were 7 patients in group land 4 patients in group II who experienced dreaming. Conclusions: The use of low dose ketamine together with midazolam as supplement for spinal anesthesia is helpful in anesthetic practice.