丁丙诺啡复合咪唑安定用于宫颈癌根治术的临床观察  

Clinical observation of intravenous buprenorphine-midazolam in operation of uterine cervix cancer

作　　者：赵新京[1] 单东海 张义长[1] 

机构地区：[1]西安交通大学医学院第一附属医院麻醉科,陕西西安710061 [2]安康市人民医院麻醉科,陕西安康725000

出　　处：《现代肿瘤医学》2010年第5期986-988,共3页Journal of Modern Oncology

摘　　要：目的:观察静脉注射丁丙诺啡-咪唑安定用于宫颈癌根治术时对应激反应的影响,及其镇静和消除内脏牵拉反应的效果。方法:60例硬膜外麻醉下行宫颈癌根治术患者,随机分为B组(丁丙诺啡0.15mg+咪唑安定4mg为1U)和F组(芬太尼0.1mg+咪唑安定4mg为1U),每组30例。手术开始前5min静脉缓慢注射辅助药物3/4-1U。在病人入室后和用药后10、30min分别抽静脉血查皮质醇、血糖。观察并记录用药时和用药后5、10、30min平均动脉压、心率、脉搏血氧饱和度、呼吸频率、患者镇静程度、术中发生的牵拉反应。结果:两组病人在用药后10min血浆皮质醇升高,与术前相比有统计学差异(P<0.05);F组病人在麻醉后30min血浆皮质醇升高,与B组对比有显著性差异(P<0.05),两组病人的血糖在用药后10min、30min均较术前升高,有统计学差异。B组镇静和消除内脏牵拉反应的作用明显强于F组(P<0.05);两组对循环及呼吸均无明显影响(P>0.05)。结论:丁丙诺啡-咪唑安定能安全地辅助用于宫颈癌根治术,术中应激反应较芬太尼轻,且能有效地增强镇静和消除内脏牵拉反应,对呼吸和循环无明显影响。Objective：To investigate the sedative, preventive effects against entrails pain and the influence of cir- culation and respiratory of intravenous administration of buprenorphine - midazolam in patients under epidural anes- thesia in the operation of uterine cervix cancer. Methods： Sixty patients undergone uterine cervix cancer surgery were divided randomly into two groups （n = 30）. Group B received 0.15mg buprenorphine ＋ 4rag midazolam;Group F re- ceived O. ling fantanyl ＋ 4mg midasolam. All the drugs or 3/4 of the dose were intravenously injeeted 5 minutes be- fore skin incision. Cortisol and blood sugar level at defined time were measured and compared. The blood pressure, heart rate, SpO2 and respiratory frequency were monitored. The degree of sedation and the entrails pain were recorded during the operation. Results：Ten min after administer, the levels of eortisol in blood was higher than those before the operation （P 〈 0.05 ） . Group F was significdlady higher than group B after 30rain administration （ P 〈 0.05 ）. Be- sides, blood sugar in both groups was higher than those before the operation （ P 〈 O. 05 ） . Group B was significantly better in sedative action, decreasing ent rails pain than ~roup F （ P 〈 0.05 ）. Both two groups had no significant influ- ence on circulation and respiratory （P 〉 0.05）. Conclusion： Buprenorphine -midazolam could relieve the increase of cortisol and blood sugar content resulting from stress response in the operation of uterine cervix cancer. Buprenor- phine -midazolam also can increase sedative action, decrease entrails pain, and does not significantly influence circu- lation and respiratory under epidural anesthesia. It can be safely used in epidural anesthesia in the operation of uterine cervix cancer.

关 键 词：丁丙诺啡 咪唑安定 芬太尼 宫颈癌根治术 

分 类 号：R730.56[医药卫生—肿瘤]