Postoperative Sedation after Major Surgery with Midazolam or Propofol in the ICU: Effects on Amnesia and Anxiety

比较接受Midazolam及Propofol镇静之術俊加護重症病患失憶程度與焦慮之緩解

蕭鵬卿(Peng-Ching Hsiao) ； 湯玉英(Yu-Ying Tang) ； 廖文進(Wen-Jinn Liaw) ； 張玉坤(Yue-Cune Chang) ； 李雅欣(Ya-Hsin Lee) ； 陳法章(Fa-Chang Chen) ； 王桂芸(Kwua-Yun Wang)

《Acta Anaesthesiologica Taiwanica》 44卷2期 (2006/07) Pp. 93-99

摘要

Background: Propofol and midazolam are commonly used in the ICU to alleviate physical and psychological disturbances in consequence of anxiety. This study was conducted to assess and compare the impact of postoperative sedation after major surgery with midazolam or propofol on amnesia and anxiety in conscious patients under intensive care.
Methods: One hundred and two adult patients irrespective of sex and age, receiving thoracic, abdominal or other major truncal surgery necessitating close care at the ICU, were randomly allocated into midazolam or propofol group. Prior to surgery, all patients were subjected to evaluation of the levels of anxiety and amnesia, which was repeated on the following morning with the level of anxiety and the level of amnesia assessed just before and 30 min after cessation of midazolam or propofol medication, respectively.
Results: There were no significant differences between the two groups regarding gender, age, types of analgesics used, and anxiety. In both groups, the levels of anxiety (P＜0.001) and amnesia (P＜0.001) were improved significantly over the following day. Midazolam had more pronounced effects on amnesia than propofol (P＜0.001). There were no significant differences between the two groups in the pre- or post-drug anxiety (P=0.189).
Conclusions: Both midazolam and propofol are effective amnesic and anxiolytic drugs. Midazolam tends to have more favorable effects on amnesia. It is speculated that combination of propofol and midazolam may give better results for treating critically ill ICU patients, the confirmation of which necessitates further study.

關鍵字

Midazolam ； Propofol ； 焦慮 ； 失憶

並列摘要

Background: Propofol and midazolam are commonly used in the ICU to alleviate physical and psychological disturbances in consequence of anxiety. This study was conducted to assess and compare the impact of postoperative sedation after major surgery with midazolam or propofol on amnesia and anxiety in conscious patients under intensive care.
Methods: One hundred and two adult patients irrespective of sex and age, receiving thoracic, abdominal or other major truncal surgery necessitating close care at the ICU, were randomly allocated into midazolam or propofol group. Prior to surgery, all patients were subjected to evaluation of the levels of anxiety and amnesia, which was repeated on the following morning with the level of anxiety and the level of amnesia assessed just before and 30 min after cessation of midazolam or propofol medication, respectively.
Results: There were no significant differences between the two groups regarding gender, age, types of analgesics used, and anxiety. In both groups, the levels of anxiety (P＜0.001) and amnesia (P＜0.001) were improved significantly over the following day. Midazolam had more pronounced effects on amnesia than propofol (P＜0.001). There were no significant differences between the two groups in the pre- or post-drug anxiety (P=0.189).
Conclusions: Both midazolam and propofol are effective amnesic and anxiolytic drugs. Midazolam tends to have more favorable effects on amnesia. It is speculated that combination of propofol and midazolam may give better results for treating critically ill ICU patients, the confirmation of which necessitates further study.

並列關鍵字

Midazolam ； Propofol ； Anxiety ； Amnesia