Comparison Study About Midazolam As Premedication In Different Ways Of Administration

Objective To investigate the clinical effection of midazolam as premedication by intramuscular, oral, intravenous three ways, and compared with traditional premedication (Phenobarbital by intramuscularly).Methods80cases of ASA Ⅰ～Ⅱ grade patients, which aged20-60years, weight40-75kg, that undergoing oral and maxillofacial surgery under general anesthesia were selected. The patients that heart, liver and renal fuction insufficiency, mental illness, take psychotropic drugs and can not normal exchange one day after surgery such as tracheotomy patients were excluded. These patients were randomly divided into four groups by different medication30min in the preoperative, each group was20cases (n=20). Group A were given midazolam0.06mg/kg by intramuscular, Group B were given midazolam0.04mg/kg by intravenous, Group C were given midazolam7.5mg by oral, D group were given100mg Phenobarbital by intramuscular as the control group. Recorded underlying values, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and blood oxygen saturation (SPO2) after10minutes,20minutes,30minutes or60minutes, and observated the respiratory depression of patients after medication; Recorded Ramsy sedative-hypnotic scores after30minutes or60minutes; Recorded anxiety AVAT score the day before surgery and the day of surgery after medication30minutes or60minutes, Gived patients three fruit such as oranges, watermelons and tomatoes at30minutes or60minutes before surgery, and observated patients anterograde amnesia one day after surgery.Results The MAP in group B after administration10,20,30min, which decreased compared with before(P<0.05), and SpO2in group B after administration10min, slightly decreased compared with baseline(P<0.05), but the other groups had no significantly change (P>0.05); The anxiety score in A, B, C groups, which decreased significantly compared with one day before administration (P<0.05%and the patients of pre-anesthetic sedation Ramsy rating reached a satisfactory state in Group B were the most, which17cases(85%), second was Group C, followed by13cases (65%); Anterograde amnesia:group A14cases(70%), group B9cases(45%), group C15cases(75%), group D0case(0%).Conclusion Midazolam has the advantages of good sedative-hypnotic, anti-anxiety and anterograde amnesia, as a preoperative medication the effect of midazolam is better than Phenobarbital; The effect that patients are given midazolam7.5mg by oral in preoperative is the best and most secure.