关键词: 后颅窝, 开颅手术, 咪唑安定, 异丙酚, 气管插管, 血流动力学

Abstract: Objective To compare the effects of midazolam and propofol on hemodynamics in postoperative and tracheal intubated patients with posterior fossa craniotomy. Methods For 60 patients undergoing posterior fossa craniotomy with endotracheal intubation were randomly divided into 2 groups to receive either midazolam(group M, n=30) or propofol (group P, n=30). In group M and group P patients received induction of sedation with midazolam 0.05 mg/kg and propofol 0.5 mg/kg respectively, followed by midazolam 0.05 mg/(kg·h)~ 0.2 mg/(kg·h) and propofol 0.5 mg/(kg·h)~3 mg/(kg·h). Patients could reach level 2~3 of Ramsay sedative condition. Sedation parameters(Ramsay score) and hemodynamic parameters including heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial blood pressure(MAP), cardiac output(CO), cardiac index(CI), stroke volume(SV), systemic vascular resistance(SVR) were recorded before sedation, 10 min, 30 min, 1 h, 2 h, 4 h and 8 h after sedation. Results After sedation, HR significantly decreased in both groups(P<0.05). SBP, DBP, MAP, CO and CI insignificantly decreased in both groups, SV and SVR insignificantly increased in both groups. Conclusion The use of midazolam and propofol in postoperative and tracheal intubated patients with posterior fossa craniotomy sedation is safe and efficient. Both of them have moderate and equal effect on hemodynamics.

Key words: posterior fossa, craniotomy, midazolam, propofol, endotracheal intubation, hemodynamics