| Japanese |
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| Title | フェンタニール麻酔下でのジアゼパム, ミダゾラムが循環動態に及ぼす影響 |
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| Subtitle | 原著 |
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| Authors | 小堀正雄*, 山本登**, 斉田清彦**, 細山田明義* |
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| Organization | *昭和大学医学部麻酔学教室, **菊名記念病院 |
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| Journal | 循環制御 |
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| Volume | 17 |
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| Number | 1 |
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| Page | 15-19 |
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| Year/Month | 1996/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」冠動脈再建術患者16名に対し, フェンタニール50μg・kg-1, 50%笑気, パンクロニウム0.2mg・kg-1で麻酔導入, 挿管後50%笑気で維持した. 循環動態が安定するのを待ち対照(S1)を測定した. 対象をジアゼパム(A)群, ミダゾラム(B)群に分け, 各群とも0.1mg・kg-1(S2), 0.2mg・kg-1(S3)投与時の循環系変化をS1と比較した. 0.1mg・kg-1ではA群はLVSWIで, B群はMAP, LVSWI, RPPで有意に低下した. 0.2mg・kg-1ではA群はLVSWI, RPPで有意に低下したが, MAP, CIは有意な変化は認められなかった. B群はMAP, CI, LVSWI, RPPで有意に低下した. 以上より, フェンタニール麻酔下ではジアゼパムよりミダゾラムのほうが循環抑制が大きく, とくにミダゾラム0.2mg・kg-1では著しい循環抑制が認められた. そして心疾患患者ではミダゾラムとフェンタニールとの安易な併用は危険であることが示唆された. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Diazepam, Midazolam, High-dose fentanyl |
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| English |
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| Title | A Comparison of Diazepam and Midazolam as Adjunct to High-dose Fentanyl Anesthesia for Coronary Artery Bypass Graft Surgery |
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| Authors | Masao Kobori, Noboru Yamamoto*, Kiyohiko Saida*, Akiyoshi Hosoyamada |
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| Organization | Department of Anesthesiology, School of Medicine, Showa University Tokyo, *Kikuna Memorial Hospital |
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| Journal | Circulation Control |
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| Volume | 17 |
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| Number | 1 |
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| Page | 15-19 |
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| Year/Month | 1996/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Sixteen patiants scheduled for a coronary artery bypass graft surgery were equally and randomly divided into diazepam and midazolam groups. The usefulness of diazepam and midazolam as an adjunct during high-dose fentanyl anesthesia was studied by changes in hemodynamics after an intravenous injection of 0.1 mg・kg-1 (S2) and 0.2 mg・kg-1 (S3) of either diazepam or midazolam during the induction by fentanyl (50 μg・kg-1) and 50 % nitrous oxide in oxygen anesthesia for coronary artery bypass graft surgery. These responses were then compared to changes in patients receiving the same fentanyl and 50 % nitrous oxide in oxygen anesthesia before intravenous administration of either diazepam or midazolam (control value：S1). Diazepam (0.1 mg・kg-1) produced significant decreases in left ventricular stroke work index. Midazolam (0.1 mg・kg-1) produced significant decreases in mean arterial pressure, left ventricular stroke work index and rate pressure products. There was a significant decrease in left ventricular stroke work index and rate pressure products following administraction of both drugs (0.2 mg・kg-1). Despite decrease in mean arterial pressure and cardiac index received midazolam (0.2 mg・kg-1), mean arterial pressure and cardiac index were maintained in patients who received diazepam (0.2 mg・kg-1). This study suggestes that diazepam is more advantageous than midazolam as an adjunct to highdose fentanyl anesthesia. Meticulous caution should be required when midazolam in doses as small as 0.2 mg・kg-1 is combined with high-dose fentanyl anesthesia. (Circ Cont 17：15〜19, 1996) |
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| Practice | Basic medicine |
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| Keywords | Diazepam, Midazolam, High-dose fentanyl |
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