【作者】 黄思渐；

【导师】 徐军美； 戴茹萍；

【作者基本信息】 中南大学 ， 麻醉学， 2012， 博士

【摘要】 目的本研究通过观察咪达唑仑对成人七氟醚最低肺泡有效浓度(MAC)的影响,拟得出咪达唑仑降低成人七氟醚MAC的幅度,为临床用药提供参考。方法30例行乳腺癌改良根治术的女性患者,ASAⅠ-Ⅱ级,年龄36-58岁,按密闭信封法分为单纯七氟醚组和七氟醚+咪达唑仑组两组,8%七氟醚吸入诱导,诱导开始后单纯七氟醚组静脉注射生理盐水5ml,七氟醚+咪达唑仑组静脉注射咪达唑仑0.1mg/kg,患者意识消失后降低七氟醚浓度至5%,2分钟后缓慢推注瑞芬太尼1μg/kg(推注时间>60秒),推注完毕1分钟行气管插管。插管后维持七氟醚呼末浓度于目标值15分钟以上后手术切皮,观察体动反应。七氟醚MAC值采用up-and-down的方法确定,得到6个交叉点后终止实验。同时记录两组心率、平均动脉压和脑电双频指数的变化。结果单纯七氟醚组的MAC为2.4±0.2%,七氟醚+咪达唑仑组的MAC为2.1±0.2%,两组比较差异具有统计学意义(P<0.05)。咪达唑仑降低七氟醚MAC的幅度为12.5%。结论诱导时单次静脉注射咪达唑仑0.1mg/kg可降低乳腺癌女性患者七氟醚最低肺泡有效浓度(MAC)12.5%。更多还原

【Abstract】 Objective The purpose of this study was to determine the effects of midazolam on the minimum alveolar concentration (MAC) of sevoflurane in adults.Methods Thirty ASA Ⅰ-Ⅱ female patients aged36-58yr, scheduled to undergo breast cancer modified radical mastectomy were enrolled in this study. The patients were divided into two groups using an airtight envelope method:a sevoflurane group and a sevoflurane combined midazolam group. Patients in the sevoflurane group were given saline(5ml) and patients in the sevoflurane combined midazolam group were given midazolam(0.1mg/kg) when anesthesia began. Anesthesia was induced with8%sevoflurane and intravenous remifentanil(1μg/kg). The end-tidal sevoflurane concentration was kept constant for more than15min before skin incision. MAC was determined using "up-and-down method". The patients’somatic responses were observed for60seconds after the incision.Results MAC of sevoflurane when used alone was2.4±0.2%. MAC of sevoflurane combined midazolam was2.1±0.2%. Midazolam reduced MAC of sevoflurane by12.5%.Conclusion Midazolam (0.1mg/kg) results in a12.5%decrease in the MAC of sevoflurane in female patients scheduled to undergo breast cancer modified radical mastectomy.更多还原