咪唑安定复合地佐辛对下腹部硬膜外麻醉中的患者镇静遗忘的影响  

Effects of midazolam combined with dezocine on sedation and amnesia in patients with lower abdominal epidural anesthesia

作　　者：李侠[1] 何文胜[1] 米晓艳[1] 姜维[1] 史天伍[1] 王立奎[2] 

机构地区：[1]安徽医科大学附属合肥医院、合肥市第二人民医院,安徽合肥230046 [2]安徽医科大学第一附属医院,安徽合肥230031

出　　处：《中西医结合心血管病电子杂志》2014年第5期86-88,共3页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的：观察咪唑安定复合地佐辛在下腹部硬手术膜外麻醉中的应用效果，以及其对静遗忘的影响。方法择期在硬膜外麻醉下行下腹部手术的患者120例，随机分成3组：氟哌利多＋哌替啶组（DP 组）：硬膜外穿刺阻滞完善后，静脉注入氟哌利多0．05 mg·kg-1和哌替啶1．0 mg·kg-1；咪唑安定＋芬太尼组（MF组）：硬膜外穿刺阻滞完善后，静脉注入咪唑安定0．04 mg·kg-1，芬太尼1．0μg·kg-1；咪唑安定＋地佐辛组（MD组）：硬膜外穿刺阻滞完善后，静脉注入咪唑安定0．04 mg·kg-1，地佐辛0．2mg·kg-1，所有给药均稀释到5ml，缓慢静脉推注。观察全部患者一般情况和给药前（T1），给药后20min（T2）和给药后40min（T3）三个时刻所有患者行改良警觉和镇静评分（OAA/S），并记录遗忘情况，同时观察术中各类不良反应。结果镇静方面，在T1点三组间OAA/S评分无显著性差异，在T2点，三组间OAA/S低分层（0～2）人数均增加，但MF组合MD组OAA/S低分层（0～2）人数显著高于DP组，P＜0．05，在T3点，三组低分层人数略有下降，但MF组和MD组低分层人数仍要显著高于DP组。在三个时间段，DP组的OAA/S评分变化不明显，差异无显著性；MF组低分层人数有先升高后降低的趋势，差异未达到显著性，P＝0．061；MD组低分层人数显著升高然后降低，三个时间段变化差异有统计学意义，P＝0．012。遗忘方面，三组在T2时间的遗忘情况均显著增加，在T3时间又继续缓慢增加，但在三个时间段，三组间差异均没有显著性，MD组有高于DP组和MF组的趋势，但趋势变化无显著性。各组不良反应没有显著差异。结论咪唑安定复合芬太尼在下腹部硬膜外麻醉中可达到良好的镇静遗忘作用的影响。Objective To investigate the influence caused by midazolam combined with dezocine on sedation and amnesia during epidural anesthesia in lower abdominal operation.Methods 120 patients undergoing elective lower abdominal operations under epidural an-esthesia were randomized into three groups：droperidol and pethidine group （group DP）：droperidol （0.05 mg · kg-1 ）and dezocine （1.0 mg·kg-1）were slowly injected after epidural puncture;midazolam and fentanyl group（group MF ）：midazolam（0.04 mg·kg-1） and fentanyl（1 .0μg · kg-1 ） were slowly injected after epidural puncture;midazolam and dezocine group （group MD ）：midazolam （0.04 mg·kg-1 ）and dezocine（0.2mg·kg-1 ）were slowly injected after epidural puncture,while ,all above drugs were diluted to 5ml with normal saline.OAA/S （the improved alertness and sedation scores）and amnesia of all the patients were observed at the following times：the time of drugs given before（T1 ）,20min after the treatment（T2 ）and 40 min after the treatment（T3 ）.In addition,general condi-tions of all patients and various intraoperative adverse reactions were also observed.Results In the sedation,OAA/S in three groups were no significant differences at T1,low scores（0 ~2）of OAA/S in three groups significantly increased at T2,while,low scores of OAA/S in group MF and MD were higher than those in group DP（P〈0.05）,the patients of low scores of OAA/S in three groups decreased at T3,but those in group MD and group MF were significantly higher than those in group DP at T3.The changes of OAA/S in group DP were no signifi-cant at three time-point;The patients of low scores in group MF increased at first and decreased at last,the difference was no significant （P=0.061）;The patients of low scores of OAA/S in group MD increased at first and decreased at last,the difference was no significant （P=0.012）.In amnesia,forgetting cases in three groups significantly increased at T2 ,and slowly increased at T3,but the differences were n

关 键 词：咪唑安定 地佐辛 硬膜外麻醉 镇静 遗忘 

分 类 号：R971.3[医药卫生—药品]