Abstract:

【Abstract】〓Objective〓To compare the effects of dexmedetomidine and midazolam on memory in patients with anxiety. Methods〓Sixty patients with Anxiety Visual Analog Test (AVAT)>30 mm, ASA Ⅰor Ⅱ,who were scheduled for hypogastrium and lower limbs surgery under combined spinal-eunder anesthesia were randomly divided into four groups(n=15,each group): dexmedetomidine (DXM) 0.5 µg·Kg^-1 group (group D_0.5), DXM 1 µg·Kg^-1 group (group D₁), midazolam group (group M) and saline group(group C). After spinal anesthesia in L2/3, patients were infused intravenously with dexmedetomidine at 0.5 µg·Kg^-1 in Group D_0.5,1 µg·Kg^-1 in group D₁, midazolam at 0.07 mg·Kg^-1 in group M and saline 10 ml in group C over 10 minutes..AVAT, Rasmay score and memory function were evaluated at preoperation,.before and thirty minutes after drug infusion. Memory function were evaluated again 4 hours after operation. Mean blood pressure (MBP), heart rates (HR), SpO₂,.respiratory rates (RR)of patients during operation were recorded..Results〓Patients in groups of D_0.5,.D₁ and M had significant sedation and decrease in anxiety after drug infusion when compared to preoperation(P<0.05 for all groups),and also had anterograde amnesia effect compared to group C (P<0.05 for all groups). The degree of anterograde amnesia in group D₁ was significantly higher in group D₁ than that in group D_0.5 (P<0.05), but was the same to that in group M(P>0.05)..MBP,.HR in groups of D_0.5 and D₁ were lower than those in group M and group C..The respiratory rates had no significant difference among all groups. However,.two patients in group M had a decrease in SpO₂ below 94%. Conclusion〓Dexmdetomidine has significant effects on antianxiety and sedation, and has an anterograde amnesia in patients with anxiety. The degree of anterograde amnesia at dexmedetomidine 1 µg·Kg^-1 has the same effect as 0.07 mg·Kg^-1 of midazolam.

Key words: Dexmedetomidine, Midazolam, Anxiety, Memory

摘要：

【摘要】〓目的〓比较右美托咪定和咪唑安定对焦虑患者记忆功能的影响。 方法〓60例择期在腰硬联合麻醉下行下腹部或下肢手术且焦虑评分>30 mm的患者,随机等分为4组(n=15):右美托咪定(dexmedetomidine, DXM)0.5 µg·Kg^-1组(D0.5组)、右美托咪定1 µg·Kg-1组(D1组)、咪唑安定组(M组)和对照组(C组)。各组分别在L2/3间隙穿刺麻醉,麻醉平面固定后,分别于10 min内泵注DXM 0.5 µg·Kg^-1、DXM 1 µg·Kg^-1、咪唑安定0.07 mg·Kg^-1和生理盐水10 mL。评估各组患者术前及用药前、用药后30 min的焦虑、镇静程度及记忆情况以及手术结束后4小时的记忆情况。记录并比较4组患者术中的平均压(MBP)、心率(HR)、血氧饱和度(SpO₂)、呼吸次数(RR)等。 结果〓D_0.5、D₁及M组用药后均有一定程度的镇静作用,焦虑程度均较术前明显减轻(P<0.05)。与对照组相比,D_0.5、D₁、M组均有顺行性遗忘作用(P<0.05),D1组顺行性遗忘程度明显高于D_0.5组(P<0.05),与M组相当(P>0.05)。用药后D_0.5、D₁组MBP和HR低于M、C组(P<0.05)。各组RR无明显差异(P>0.05),而M组有2人SpO2下降至94%以下。 结论〓右美托咪定对焦虑患者有明显的镇静、抗焦虑作用,对记忆的影响与剂量有关。1 µg·Kg^-1右美托咪定的顺行性遗忘作用与咪唑安定0.07 mg·Kg-1相当。

关键词: 右美托咪定, 咪唑安定, 焦虑, 记忆