丙泊酚与咪唑安定辅助硬膜外阻滞的临床分析  

CLINICAL ANALYSIS OF THE HELPER EFFECTS OF PROPOFOL AND MIDAZOLAM ON EPIDURAL ANESTHESIA

作　　者：祝建新[1] 王祖谦[1] 

机构地区：[1]青海大学附属医院麻醉科

出　　处：《青海医学院学报》2006年第2期124-126,共3页Journal of Qinghai Medical College

摘　　要：目的探讨丙泊酚与咪唑安定在辅助硬膜阻滞麻醉中的效果。方法40例中下腹部手术患者,根据手术部位均行硬膜外阻滞,手术开始后Ⅰ组静脉注射丙泊酚(2.5mg/kg);Ⅱ组静脉注射咪唑安定(0.05mg/kg);分别观察对麻醉辅助效能、循环功能、呼吸功能的影响。结果丙泊酚组起效时间显著快于咪唑安定组(P<0.05),恢复时间丙泊酚组也显著快于咪唑安定组;丙泊酚组在给药后2 m in收缩压(SBP)、舒张压(DBP)均降低(P<0.05),5 m in后逐渐恢复正常,而心率逐渐变慢,咪唑安定组对循环系统的影响无统计学意义。两组对呼吸系统均有不同程度的影响,表现为潮气量(VT)、分钟通气量(MV)、经皮血氧饱和度(SaO2)均降低,但丙泊酚组降低幅度大于咪唑安定组,经面罩给氧情况下仍在正常生理范围内。通过观察还发现丙泊酚组在手术探查及冲洗腹腔时牵拉反应轻、肌松好,眀显优于咪唑安定组。结论丙泊酚或咪唑安定在辅助硬膜外阻滞中,均可安全有效提高麻醉质量,但术中应当严密加强呼吸及循环监测和管理,对无明显心脏疾患者,可首选丙泊酚,如合并严重心脏病患者应选用咪唑安定。Objective To investigate the effects of the association effects of Propofol and Midazolam on epidural anesthesia. Methods 40 cases of patients who were performed the operation in middle or lower abdomen was carried out the peridural anesthesia. At the beginning of the operation, Propofol and Midazolam were administrated to the group 1 by iv. With the dosage of 2.5mg/kg; group 2 was injected Midazolam 0.05mg/kg. The influence on anesthesia association, the function of circulation and respiratory were observed. Results The speed of effectiveness of Propofol was significantly faster than Midazolam and the restore time were as same as mentioned above. The caused the blood pressure declined after 2 min （ P 〈 0.05 ）. The blood pressure was restored to normal but the heartbeat gradually slowed down. There was no significant difference in the influence of Propofol on circulation system. Both groups showed different degree of influence on respiratory system including reduced VT, MV and showed better effectiveness than Midazolam in the course of abdominal operation having the advantage of slight drag reaction and good muscle relaxation. Conclusion Both of Propofol and Midazolam can promote the quality of anesthesia making the operation safe and available. It ought to be strengthening that an adequate monitoring concerning both circulation and respiratory should be taken. Propofol may as the first choice when there is no obvious heart disease. Midazolam is chosen when complicated with serious heart problem.

关 键 词：咪唑安定 丙泊酚 硬膜外阻滞 

分 类 号：R971.2[医药卫生—药品]