MIDAZOLAM ENHANCES ANTEROGRADE BUT NOT RETROGRADE-AMNESIA IN PEDIATRIC-PATIENTS
MIDAZOLAM ENHANCES ANTEROGRADE BUT NOT RETROGRADE-AMNESIA IN PEDIATRIC-PATIENTS
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DOI：
10.1097/00000542-199301000-00009
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发表时间：
1993-01-01
期刊：
影响因子：
8.8
通讯作者：
BEATON, C
中科院分区：
文献类型：
--
作者：
TWERSKY, RS;HARTUNG, J;BEATON, C
背景咪达唑仑镇静已被证明可以减少儿科患者在全身麻醉诱导前显示的一到四张卡片的回忆。这一有希望但有限的发现促使我们研究咪达唑仑镇静对择期手术儿童的逆行和顺行回忆和识别的影响。采用双盲研究设计，将40例4-10岁的患者随机分配，使用Devilbiss #286雾化器接受0.2 mg/kg鼻内咪达唑仑或0.2 ml/5 kg安慰剂（蒸馏水）。为了评估术前事件的术后记忆，使用为此目的设计的一系列图片卡进行回忆和识别任务。逆行性遗忘通过术后回忆和识别咪达唑仑/安慰剂给药前显示的卡片来测量，顺行性遗忘通过术后回忆和识别咪达唑仑/安慰剂给药和全身麻醉诱导之间间隔期间显示的卡片来测量。与安慰剂相比，咪达唑仑组术后记忆能力明显下降，（P < .003）和识别（P < .001）咪达唑仑/安慰剂给药后显示的卡片（顺行性遗忘）。值得注意的是，两组患者术后回忆或识别咪达唑仑/安慰剂给药前显示的卡片的能力无差异（逆行性遗忘）。这些结果支持并扩展了咪达唑仑减少顺行回忆的推断。此外，我们的研究结果表明，咪达唑仑减少顺行性识别，从而提供部分顺行性遗忘，而不影响逆行记忆的儿科患者。
Background. Midazolam sedation has been shown to diminish recall of one to four cards shown prior to induction of general anesthesia in pediatric patients. This promising but limited finding prompted us to investigate the effect of midazolam sedation on retrograde and anterograde recall and recognition in children scheduled for elective surgery.Methods. Forty patients aged 4-10 yr were randomized using a double-blind study design to receive either 0.2 mg/kg intranasal midazolam or 0.2 ml/5 kg placebo (distilled water) using a Devilbiss #286 atomizer. To assess postoperative memory of preoperative events, recall and recognition tasks were performed using a series of picture cards designed for this purpose. Retrograde amnesia was measured by postoperative recall and recognition of cards shown prior to midazolam/placebo administration, and anterograde amnesia was measured by postoperative recall and recognition of cards shown during the interval between midazolam/placebo administration and induction of general anesthesia.Results: Compared to placebo, the midazolam group experienced a significant postoperative reduction in ability to both recall (P < .003) and recognize (P < .001) cards shown subsequent to midazolam/placebo administration (anterograde amnesia). In distinction, there was no difference between groups in postoperative ability to recall or recognize cards shown prior to midazolam/placebo administration (retrograde amnesia).Conclusions. These results support and extend the inference that midazolam diminishes anterograde recall. In addition, our findings indicate that midazolam diminishes anterograde recognition, thereby providing partial anterograde amnesia without affecting retrograde memory in pediatric patients.