- 期刊
Co-administration of Midazolam Decreases Propofol Dose during Anesthesia in Endoscopic Laryngeal Microsurgery
於耳鼻喉科內視鏡手術麻醉中使用Midazolam可降低Propofol的劑量
摘要
Background: Propofol is commonly used in total intravenous anesthesia (TIVA) for brief surgical procedures because it offers rapid recovery and has fewer side effects. However, concomittent use of other adjuvant agents has been considered so that the same anesthetic effects can be achieved at lower doses of propofol which is more expensive without compromising rapid recovery and increasing the adverse effects. This study was therefore designed to evaluate the co-administration of midazolam and propofol during anesthesia for endoscopic microsurgery and test its influences on the consumption of propofol and the quality of anesthesia. Methods: Forty-two patients receiving selective endoscopic microsurgery were enrolled in this study. All patients received high frequency jet ventilation (HFJV) under TIVA. The control group (n = 21) received propofol (20 mg/5 s) during induction and 10 mg/kg/h as maintenance. The study group (n = 21) received midazolam (0.06 mg/kg) and propofol (20 mg/5 s) for induction with propofol 8 mg/kg/hr for maintenance. Doses of propofol, vital signs, recovery time, post-anesthetic high cortical function, and adverse events were evaluated and compared. Results: Co-administration of midazolam and propofol in TIVA could reduce the induction dose and the total dose of propofol by 51% and 26% respectively but still achieve the same anesthetic effects. Vital signs and recovery were not influenced, and incidence of adverse effects did not increase. Conclusions: Our result suggests that co-administration of midazolam and propofol in TIVA appears to be a safe, effective, and economic alternative to that with propofol alone. The effects were synergic but side effects were not.
並列摘要
背景：Propofol具有恢復快的特性，常用於全靜脈注射麻醉。然而，若欲併用其它輔助性藥物以降低propofol的劑量，則須考慮其是否不影響麻醉及恢復品質。本實驗目的即在評估併用midazolam於耳鼻喉科的內視鏡顯微手術中，對propofol用量及麻醉的影響。方法：將135個ASA體位分等第I級的健康病人隨機分成九組，每一組均在誘導前2分鐘分別注射生理食鹽水、nicardipine或verapamil。誘導前使用propofol 2.5毫克/公斤，vecuronium 0.2毫克/公斤，並記錄平均動脈壓、心跳、吐氣末期二氧化碳和氧氣飽和度。mg/kg，再給propofol直到睡著後，以propofol 8 mg/kg/h為維持劑量。比較兩組在propofol的劑量，心跳，血壓，恢復時的品質及副作用。結果：併用midazolam可降低propofol之誘導劑量51％及總劑量26％，麻醉中之生命現象及麻醉後恢復狀況無統計差異。結論：在全静脈注射麻醉之誘導時併用midazolam及propofol是一種安全，有效，經濟的選擇。藥效有加成作用，可減少propofol的劑量，而且副作用並未增加。