【摘要】 目的 观察咪唑安定加入布比卡因对蛛网膜下腔麻醉维持时间和麻醉效果的影响。方法 40例ASA Ⅰ级子宫切除病人随机分为咪唑安定组(试验组，n=20)和对照组(n=20)。咪唑安定组蛛网膜下腔注入0.5%重比重布比卡因2.5ml加咪唑安定1mg(0.2ml)，对照组注入0.5%重比重布比卡因2.5ml加生理盐水0.2ml。观察运动神经阻滞(改良Bromage)、感觉神经阻滞(针刺法)、镇痛时间(VAS)、术者和患者对麻醉的满意率。结果 咪唑安定组感觉和运动神经阻滞时间显著延长(P<0.01)，术者和患者对麻醉的满意率提高(P<0.05)。咪唑安定组有效镇痛时间也显著延长(P<0.001)。两组血流动力学、不良反应情况差别无显著性。结论 咪唑安定加入布比卡因能显著延长麻醉作用时间，麻醉效应增强，而不良反应未见增加。

    【关键词】 咪唑安定；布比卡因；蛛网膜下腔麻醉

    The effect of intrathecal midazolam on bupivacaine spinal anesthesia

    WANG Huan-liang,ZHANG Li,LI Jian-jun.

    Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan 250012,China

    【Abstract】 Objective To investigate the effect of adding midazolam to intrathecal bupivacaine on the duration and quality of spinal blockade.Methods Forty ASA Ⅰ patients undergoing hysterectomy were selected for the study. The patients were randomly allocated to receive 2.5ml of 0.5% hyperbaric bupivacaine intrathecally with either 0.2ml 0.9%NS or midazolam(1mg) using a combined spinal epidural technique. The duration and quality of sensory and motor block, perioperative analgesia, hemodynamic changes, and sedation levels were assessed.Results The duration of sensory block (time to regression to the S2 segment) was significantly longer in the midazolam group than the control group (218±27 min vs. 165±45 min;P<0.001). The duration of motor block was also prolonged in the midazolam group as compared with the control group (225±45 min vs. 180±30 min;P<0.01). 90% of the patients in the midazolam group, the quality of block was adequate during the intra-operative period as compared with only 65% of the patients in the control group (P<0.05). The duration of effective analgesia was longer in the midazolam group than in the control group (199±14 min vs.103±5 min; P<0.001). Blood pressure, heart rate, oxygen saturation and sedation scores were comparable in both groups.Conclusion The addition of intrathecal midazolam to bupivacaine significantly improves the duration and quality of spinal anaesthesia and provides prolonged perioperative analgesia without significant side-effects. ......