神经安定镇痛术在射频消融治疗中的应用  

Application of Neuroleptanalgesia in radiofrequency ablation

作　　者：周芳[1] 王龙[1] 胡红耀[2] 区家乐[2] 

机构地区：[1]武汉大学人民医院麻醉科,湖北武汉430060 [2]武汉大学人民医院介入放射科,湖北武汉430060

出　　处：《海南医学》2012年第4期97-98,共2页Hainan Medical Journal

摘　　要：目的探讨神经安定镇痛术在射频消融治疗中的应用效果。方法 32例择期行射频消融术的患者,随机分为局麻镇痛组和神经安定镇痛组,各组16例。局麻镇痛组采用1%的利多卡因局部浸润麻醉,神经安定镇痛组采用咪达唑仑0.04 mg/kg、芬太尼1μg/kg、氟比洛芬酯1 mg/kg静脉给药。观察患者心率、血压、脉搏氧的变化,记录疼痛程度和恶心、呕吐、眩晕的发生率。结果局麻组恶心、呕吐7例,心率、血压变化>20%12例,SPO2下降12例,术中疼痛剧烈而不能耐受手术者2例。神经安定镇痛组无一例出现恶心、呕吐、SPO2下降及不能耐受手术者,心率变化>20%1例,术后呕吐眩晕1例。结论射频消融治疗患者,与局麻镇痛比较,神经安定镇痛能提供更好的手术麻醉条件。Objective To investigate the value of Neuroleptanalgesia（NLA） in the therapy of radiofrequency ablation（RFA）.Methods Thirty-two patients scheduled for RFA were randomly divided into two groups,each with 16 cases： the local analgesia group（received local analgesia by 1% lidocaine） and Neuroleptanalgesia group（received NLA by 0.04 mg/kg Midazolam,1 μg/kg Fentanly,1 mg/kg Flurbiprofen Axetil Injection）.The changes of vital signs,,including heart rate（HR）,Blood pressure（BP）,SpO2,the sense of gastrointestinal discomfort and pain during the surgery were compared between the two groups.Results In local analgesia group,7 cases were found with gastrointestinal discomfort during the surgery,12 cases with apparent changes of HR and/or BP（20%）,12 cases with decline of SpO2 and 2 cases suffered unendurable pain.In Neuroleptanalgesia group,no patient was found with gastrointestinal discomfort,decline of SpO2 and unendurable pain;one patient was found with apparent changes of HR and/or BP（20%）;and one had vomiting and dizziness after the surgery.Conclusion In terms of painless,safety and humanity,NLA is preferred for RFA than local analgesia.

关 键 词：神经安定镇痛 射频消融术 局部麻醉 

分 类 号：R61[医药卫生—外科学]