【摘要】 咪唑安定（MID）硬膜外注射的节段性镇痛效应及其对患者血流动力学（MAP、HR、SI、CI、TFI、VET、EVI、SVRI、IC、PFI、LVWI、RPP、）与通气功能(VT、RR、V_E、FEV₁、I-E_tO₂、P_ETCO₂、SpO₂)的影响。44例患者（ASA Ⅰ～Ⅱ）随机分成四组:E₁组硬外注MID 0.05mg/kg,E₂组硬外注MID 0.1mg/kg,V₁、V₂组为静脉组,剂量与E₁、E₂组相同。结果:（1） E₁、E₂组均产生节段性镇痛效应,其平面分别为T6.2±0.6～T11.3±0.3、T6.3±0.7～T11.9±0.4,静脉组无此现象,（2） E₁、E₂与V₁、V₂组均可使HR一过性增快,SI、CI、MAP下降,LVWI、IC、PFI、EVI、降低,心肌耗氧减少,且随着MID剂量增加,变化率增大;（3） MID可使V_T、V_E减少,SpO₂降低。更多还原

【Abstract】 To determine the differences in analgesic, hemodynamic and ventilatory effects between epidural and intravenous midazolam （MID）, 44 adult patients, ASA grade Ⅰ to Ⅱ, scheduled for elective upper abdominal surgery. were randomly allocated to receiving epidural MID 0.05 mg/kg （group E₁） or 0.1 mg/kg （group E₂）. or intravenous MID 0.05 mg/kg （group V₁） or 0.1 mg/kg （group V₂）, respectively, The analegic effect was evaluated by pin-prink test, following MID administration. The hemodynamie and ventilatory values were measured by impedance cardiogra phy and side stream spirometry, before and 1.3, 5, 10, 15 and 20 mins after MID administration. Tbe results showed that the segmental spinal analgesia occured with MID in group E₁ and E₂, but no analgesia was produced with WID in group V₁ and V₂. Following MID administration in four groups, HR increased during first 5 mins （P<0.05）. and then returned to previous level; time of ventricular ejection, lung water index and SVRI kept stable（P>0.05）; CI, SI. LVWI, MAP, RPP and indices of myocardial eonstraction, cardiae peak flow and blood ejection velocity decreased slightly（P<0.05）. There weren’t significant differences in hemodynamie values among four groups. （P>0.05）. After MID administration, SpO₂ and VT were reduced （P<0.05）, RR and P_ETCO₂ remained stable（P>0.05）, and the inspiratory end-tidal oxygen content difference was elevated transiently （P<0.05）, in four groups; VE kept constant in group E₁ and V₁（P>0.05） and went down in group E₂ and V2（P<0.05）. Except VT was higher in group E₁ or E₂ in 5mins following epidural MID than that in group V₁ or V₂ individually （P<0.05）, there were not significant differences in ventilatory values between group V₁ and E₁ or group V₂ and E₂（P>0.05）.更多还原