术前应用咪达唑仑有利于全身麻醉诱导时的面罩通气：一项随机临床试验。
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Midazolam Premedication Facilitates Mask Ventilation During Induction of General Anesthesia: A Randomized Clinical Trial.
背景与目的
在全身麻醉诱导期，适当的面罩通气对于为无意识的患者提供足够的氧气至关重要。 咪达唑仑对呼吸道平滑肌有松弛作用，我们假设预先给予咪达唑仑镇静可以促进麻醉诱导期的面罩通气。
方 法
在全身麻醉下接受择期手术的患者被随机分为两组。 咪达唑仑组在转移到手术室前3分钟在准备区给予咪达唑仑。 对照组给予生理盐水。 主要结果是在诱导期面罩通气困难，使用Warters量表评估。
结 果
共有97名患者：对照组49名，咪达唑仑组48名。 咪达唑仑组患者在Warters量表上的面罩通气难度评分显著低于对照组（平均[标准差]，0.92 [1.13] vs 0.19 [0.57]；估计差异[95％置信区间]， 0.73 [0.37-1.09]； P <.001）。 咪达唑仑组难以进行面罩通气（≥2Warters量表）的发生率显著低于对照组（风险比[95％置信区间]，0.15 [0.03-0.72]；P = .015）。
结 论
这项随机临床试验表明，术前应用咪达唑仑有利于全身麻醉诱导时的面罩通气。
原始文献摘要
Abstract
BACKGROUND:
During induction of general anesthesia, proper mask ventilation is crucial for supplying sufficient oxygen to unconscious patients. Midazolam has a relaxing effect on airway muscles. We hypothesized that sedative premedication with midazolam would facilitate mask ventilation during anesthetic induction.
METHODS:
Patients undergoing elective surgery under general anesthesia were randomized into 2 groups. The midazolam group received midazolam premedication at the reception area, 3 minutes before transfer to the operating room. Patients in the control group were treated with normal saline as a placebo. The primary outcome was difficulty of mask ventilation during induction, as evaluated using the Warters scales.
RESULTS:
A total of 97 patients completed the analysis: 49 in the control group and 48 in the midazolam group. The patients in the midazolam group showed a significantly lower mask ventilation difficulty score on the Warters scale than that of the control group (mean [standard deviation], 0.92 [1.13] vs 0.19 [0.57]; estimated difference [95% confidence interval], 0.73 [0.37-1.09]; P < .001). The incidence of difficult mask ventilation (≥2 Warters scale) was significantly lower in the midazolam group than in the control group (risk ratio [95% confidence interval], 0.15 [0.03-0.72]; P = .015).
CONCLUSIONS:
This randomized clinical trial demonstrated that midazolam premedication enhanced mask ventilation during induction of general anesthesia.
麻醉学文献进展分享
贵州医科大学高鸿教授课题组
编辑：符校魁 审校：余晓旭