咪唑安定配伍不同药物对辅助硬膜外麻醉的临床效果.doc

咪唑安定配伍不同药物对辅助硬膜外麻醉的临床效果
作者:孙焱芫熊利泽卢保华郑玉郑恒兴
【关键词】咪唑安定
关键词: 咪唑安定;麻醉,硬膜外;镇痛
摘要:目的探讨咪唑安定与芬太尼、氟哌啶及氟哌合剂(氟哌啶与哌替啶)配伍作为硬膜外辅助用药镇静、镇痛及预防术中不良反应的效果. 方法 ASA II~III行择期腹部手术患者80例,按辅助用药不同随机分为4组(n=20):氟哌合剂组(DP)、咪芬(MF)、咪哌(MP)合剂组及咪唑安定与氟哌合剂联合用药组(MDP).术前了解患者对镇静的要求,于硬膜外麻醉首剂量5~10min后静脉给药,术中观察并记录给药后10min内的BP,HR和SpO2 变化,患者镇静程度,不良反应发生率,并于术后随访患者对术中情况有无遗忘及对麻醉效果的评价. 结果 69%患者对术中镇静有明确要求;:(±)min,MP:(±)min,MDP:(±)min、明显短于DP组:(±)min(P<);而MDP组维持4级以上镇静的作用时间是(±)min显著长于其他3组[MP:(±)min;DP:(±)min;MF:(±)min](P<);伍用咪唑安定的3组患者产生遗忘作用高于DP组,且患者的满意度相对较高(P<),但各组术中牵拉反应发生率无差异,MP与MDP组舌后坠发生率较高(P<). 结论硬膜外麻醉时咪芬合剂是1~2h手术的最佳辅助用药,咪氟哌联合用药适用于镇静需求高,时间>,减少术中不良记忆,对循环呼吸干扰小,提高麻醉满意率的优点.

Keywords:midazolam;anesthesia,epidural;analgesia

Abstract:AIM To investigate the sedative,analgesic and preventive effects against side-effects of intravenous adminis-tration of midazolam(M)with binations in pa-tients undergoing abdominal surgery under epidural anesthe┐ 80ASA II~III patients,scheduled for elective abdominal surgery were randomized into four groups:Group DP,droperidol5mg+pethidine100mg as1U;Group MF,midazolam4mg+ as1U;Group MP,midazolam4mg+pethidine100mg as1U and Group MDP,DP1U+ the drugs were intravenously injected5~10min after the first dose of epidu-ral local dose of binations was se-lected to reach sedation degree of patients’requirement for sedation was asked blood pressure,heart rate and SpO2 were monitored,the de-gree of sedation and the side-effects were recorded during the patients were vi
sited to evaluate the effect of amnesia and satisfaction of 68%pa-tients had the clear requirement for sedation during the oper- were no differences in the changes of blood pressure,heart rate,SpO2 in all four for the time reaching Ramsay4of sedati