静脉注射布托啡诺咪达唑仑在硬膜外子宫切除术中的应用  

Clinical Observation of Intravenous Butorphanol Midazolam in Epidural Anesthesia for Hysterectomy

作　　者：唐海斌[1] 刘庆[1] 郑洁[1] 

机构地区：[1]泸州医学院附属中医院,四川泸州646000

出　　处：《现代临床医学》2015年第1期22-24,共3页Journal of Modern Clinical Medicine

摘　　要：目的：观察静脉注射布托啡诺咪达唑仑应用于子宫切除术中抑制牵拉反应、寒战的效果及不良反应。方法：选择ASAⅠ~Ⅱ级择期硬膜外麻醉子宫切除术的患者60例,为抑制牵拉反应,根据从静脉使用的辅助药物不同随机将病例分为布托啡诺咪达唑仑组（B组）和芬太尼咪达唑仑组（F组）。所有病例均采用分次给药方式,术中出现牵拉反应时追加首次给药的1/2剂量。观察记录HR、SBP、DBP、Sp O2、牵拉反应、寒战反应、镇静评分、术中循环稳定性以及不良反应。结果：2者均能有效抑制牵拉反应,相对B组而言,F组患者术中需反复追加药物（P〈0.05）。B组患者寒战程度明显轻于F组（P〈0.05）。2组30 min内镇静评分无明显差异,术毕镇静评分B组高于F组（P〈0.05）。B组术中循环稳定性高于F组,不良反应无明显区别。结论：静脉注射布托啡诺咪达唑仑在子宫切除术中抑制牵拉反应效果确切,术中患者循环稳定,追加用药次数少,不良反应少,并能有效预防寒战发生,总体而言优于芬太尼咪达唑仑。Objective： To observe the effects of intravenous butorphanol midazolam in controlling traction reaction,chills and adverse reactions in hysterectomy. Methods： 60 patients with ASA Ⅰ ~ Ⅱ hysterectomy in epidural anesthesia were randomly divided into B,F groups： butorphanol midazolam group and fentanyl midazolam group respectively. Drug delivery on time,and as was intraoperative traction reaction,spended half of the first dose administered. Recorded HR,SBP,DBP,Sp O2,traction reaction,chills reactions,sedation score,intraoperative cycle stability and adverse reactions. Results： Two groups effectively inhibited traction response,demanded additional drugs repeatedly in F group in intraoperation,compared with that in B group（ P 0. 05）.Chills degree in B group significantly lower than in F group（ P 0. 05）; sedation score in two groups within 30 min had no significant difference,intraoperative Bi Zhenjing score in B group was higher than in F group（ P 0. 05）; the cycling stability in B groupwas higher than in F group; but adverse reactions was no significant differencein two groups. Conclusion： Intravenous butorphanol midazolam in hysterectomy is exact effect of inhibiting traction reaction and intraoperative cycling unstability; have less additional drugs repeatedly and adverse reactions; and can effectively prevent chills; and is better than fentanyl midazolam.

关 键 词：布托啡诺 咪达唑仑 子宫切除术 牵拉反应 寒战 

分 类 号：R614.24[医药卫生—麻醉学]