The physiological and behavioral evaluation of patient-control sedation

患者自控镇静的生理和行为评估

• 批准号: 07672162
• 负责人: SOMEYA Genji
• 金额: $ 1.41万
• 依托单位: NIIGATA UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07672162/
• 关键词: PATIENT-CONTROLLED SEDATION; SEDATION; PROPOSAL; MIDAZOLAM; GRIP; OBIECTIVE EVALUATION; HYPNOTIC; EMG; patient-controlled sedation; Patient-controlled Sedation; プロッポフォール; ドルミカム

Methods : Prior to this study, written informed consent was obtained from each of the 32 subjects. They were randomly assigned to receive bolus injections of 0.075 mg/kg midazolam : group M (n=7) ; 0.7 mg/kg propofol : group P0.7 (n=15) ; or 1.0 mg/kg propofol ; group P1.0 (n=10). The changes in grip were measured by digital hand-dynamometer for 60 minutes after injection of midazolam, 30 minutes after propofol. After the control value for the grip and the EMG activity of the superficial flexor muscles of the fingers were determined, the subject received a bolus injection of designed drug for 2 minutes. And the sedative condition of the subject was evaluated by subjective and objective sedation scales. Duringexperiment, heart rate, blood pressure, respiratory rate and SpO_2 were measured. These data were analyzed using paired t-test, with p<0.05 considered statistically significant.Results : Compared to the control value for the grip, the average value in Group M decreased significantly from 0 min (75%) till 30 min (83%) after midazolam injection. The value in Group P0.7 decreased significantly at 1 min (83%) and 3 min (85%) after 0.7 mg/kg propofol injection. The value in Group P1.0 decreased significantly from 0 min (74%) till 15 min (83%) after 1.0mg/kg propofol injection. Four subjects in the group P1.0 could not grip the digital hand-dynamometer at all at 1 min after 1.0mg/kg propofol injection due to the depth of their sedation. Severe changes were not observed in heart rate, blood pressure, respiratory rate and SpO_2.Conclusion : The results suggest that a value for grip that indicates adequate sedation is below 80% of the control value and that the lockout time of PCS should be 30 minutes after bolus injection of 0.075 mg/kg midazolam, 3 minutes after that of 0.7 mg/kg propofol. Bolus injection of 1.0 mg/kg propofol appears to be inappropriate for patient-controlled conscious sedation.

方法：在本研究之前，从32名受试者中获得了书面知情同意书。随机分为三组，M组（n=7）单次静脉注射咪达唑仑0.075 mg/kg，P组（n=15）单次静脉注射丙泊酚0.7 mg/kg，P组（n=10）单次静脉注射丙泊酚1.0 mg/kg。分别于注射咪达唑仑后60 min、异丙酚后30 min用数字式握力计测量握力变化。在确定抓握的控制值和手指浅屈肌的EMG活动后，受试者接受设计药物的推注2分钟。采用主观和客观镇静量表评价受试者的镇静情况。实验过程中测量心率、血压、呼吸频率和SpO_2。结果：与对照组相比，M组注射咪达唑仑后0 ~ 30 min握力平均值显著下降（75%~ 83%），P<0.05。P0.7组在注射0.7mg/kg异丙酚后1 min（83%）和3 min（85%）显著降低。P1.0组在注射异丙酚1.0mg/kg后0 ~ 15 min显著降低（74%~ 83%）。P1.0组中4例受试者在注射1.0mg/kg丙泊酚后1 min由于镇静深度而无法抓握数字式手力计。结论：镇静效果良好的握力值应低于对照值的80%，PCS锁定时间应在0.075mg/kg咪唑安定后30 min，0.7mg/kg丙泊酚后3 min。1.0 mg/kg丙泊酚推注似乎不适合患者控制清醒镇静。

项目成果

KATSUHIKO MIUIRA: "THE PHYSIOLOGICAL AND BEHAVIORAL EVALUATION OF NEW PATIENT-CONTROLLED SEDATION WITH MIDAZOLAM AND PROPOFOL" J.JPN.DENT.SOC.ANESTHESIOL.24(3). 473-482 (1996)

KATSUHIKO MIUIRA：“咪达唑仑和异丙酚新型患者自控镇静的生理和行为评估”J.JPN.Dent.SOC.ANESTHESIOL.24(3)。

三浦勝彦: "ミダゾラムとプロポフォールの併用による新しいPatient-controlled sedationの評価" 日本歯科麻酔学会雑誌. 24. 473-482 (1996)

Katsuhiko Miura：“使用咪达唑仑和异丙酚组合的新型患者自控镇静剂的评估”日本牙科麻醉学会杂志 24. 473-482 (1996)。

三浦勝彦: "ミダゾラムとプロポフォールの併用による新しいPatient-controlled sedationの評価" 日本歯科麻酔学会雑誌. 24・3. 473-482 (1996)

三浦胜彦：“联合使用咪达唑仑和异丙酚的新型患者自控镇静剂的评估”日本牙科麻醉学会杂志 24・3（1996）。