咪达唑仑用于冠脉搭桥手术术后镇静对循环和脑氧耗的影响

摘要

目的 观察咪达唑仑对冠脉搭桥手术术后呼吸支持的患者的循环、脑氧合功能的影响,比较罗氏公司咪达唑仑(多美康)与徐州恩华药业股份有限公司咪达唑仑(力月西)的临床药效.方法 28例冠脉搭桥手术患者,按使用咪达唑仑的来源随机分为两组:多美康组(D组),力月西组(L组),两组静脉注射咪达唑仑负荷量0.03 rng/kg,维持剂量0.04 mg·kg<'-1>·h<'-1>.于用药前、用药后10、30、60、90 min采用漂浮导管测定血流动力学指标及颈内动脉血流、动脉血气、颈静脉球部血气,并测定血色素,计算脑氧耗(cMRO<,2>).结果 与用药前比较,L组30 min时心输出量(CO)、心脏指数(CI)显著降低(P<0.05);L组用药后60 min CMRO<,2>明显下降(P<0.05).结论 两种咪达唑仑对冠脉搭桥手术术后呼吸支持的患者均有较好的镇静作用,小剂量时心血管影响小,轻度降低脑氧耗.%bjective To observe the effect of midazolam on circulation and brain oxygenation of patients with breathe support after coronary artery bypass grafit (CABG), and compare the pharmacodynamics of Diamicron (Roche company) and Midazolam Injection (Nhwa Pharma corporation). Methods Twenty-eight patients under CABG were divided into two groups: Diamicron group (group D) and Midazolam group(group L). Loading dose was 0. 03 mg/kg, and maintain dose was 0. 04 mg·kg-1 · h-1. Hemodynamics data, internal carotid artery flow, arterial blood gas,Glomus Jugulare blood gas and haemoglobin were collected before medication, 10,30,60,90 min after medication by float catheter, furthermore brain oxygen consumption was computed. Results MAP decreased in both groups which change obviously in group L. CO and CI decreased at 30 min in group L(P＜0.05). CMRO2 declined at 60 min after drug administration in group L(P＜0. 05). Conclusion Both Diamicron and Midazolam injection had sedation function on patients with breathe support after CABG, small dose midazolam had little effect on cardiovascular function and decreased brain oxygen consumption slightly.