咪达唑仑对老年人三叉神经射频温控热凝术的镇静和抗焦虑效果的影响  

The sedation and anxiolytic effect of midazolam on radiofrequency control thermocoagulation with trigeminal neuralgia for elderly patients

作　　者：汪雨宣 朱浩[1] 黄碧莹[3] 张力[1] 华泽权[1] 

机构地区：[1]解放军沈阳军区总医院,辽宁沈阳110840 [2]辽宁医学院,辽宁锦州210700 [3]大连医科大学,辽宁大连116044

出　　处：《临床口腔医学杂志》2016年第1期40-42,共3页Journal of Clinical Stomatology

基　　金：辽宁省科技厅科技攻关课题(2012225014)

摘　　要：目的:探讨口服咪达唑仑在三叉神经痛老年患者射频温控热凝术中的镇静和抗焦虑效果。方法:选择60岁以上进行射频温控热凝术的三叉神经痛患者70例,随机平分为两组:A组:术前口服咪达唑仑;B组:术前无用药。A组于麻醉前60 min给药,记录两组病例给药前(基础值)、术前、穿刺时、加温1 min、3 min和术毕时的SBP、DBP、HR、SPO2、焦虑AVAT评分、镇静Ramsy改良法评分。记录治疗过程中的不良反应发生率。结果:A组手术成功率100%,B组手术成功率94.3%。两组SBP、DBP、HR、SPO2的基础值比较无统计学意义(P>0.05),与基础值比较,A组在各时段的SBP、DBP、HR均无统计学意义(P>0.05),B组在术前、穿刺时、加温1 min、3 min时的SBP、DBP、HR均升高(P<0.05);与B组比较,A组在术前、穿刺时、加温1 min、3 min和术毕时的SBP、DBP均降低(P<0.05),A组在术前、穿刺时、加温1 min、3 min时的HR降低(P<0.05),A组在术毕时的HR无统计学意义(P>0.05);SPO2在以上各时点的差异无统计学意义(P>0.05)。Ramsy评分:A组在各时段镇静Ramsy评分均在0-2级;B组各时段镇静评分均为0级。结论:口服咪达唑仑用于老年三叉神经射频术的镇静和抗焦虑效果显著。Objective：To investigate the sedative and anxiolytic effects of peroral Midazolam in radiofrequency control thermocoagulation of elderly patients with trigeminal neuralgia. Method：70 patients with trigeminal neuralgia over 60 years old who had performed radiofrequency thermocoagulation in our hospital in the year of 2014 were chosen and randomly divided into two groups：A group：taking midazolam preoperatively（n=35）;Group B：no medication preoperatively（n=35）. All the patients were administered 60 minutes before anesthesia,before administration（baseline）,before operation,puncturing,heating 1min、3min and over operation,recorded SBP,DBP,HR,SPO2,anxiety AVAT score and the sedate Ramsy score improved method. Recorded incidence of adverse reactions during the treatment. Result：The success rate of group A was 100%,the success rate of group B was 94.3 %. The baseline of SBP,DBP,HR,SPO2 in two group had no statistically significance（P〉0.05）.Compared with baseline,SBP、DBP、HR of group A all had no statistically significance（P〈0.05） before operation、puncturing、heating 1 min、3 min and over operation. SBP,DBP,HR were significantly increased（P〈0.05）of group B before operation、puncturing,heating 1 min、3 min. Compared with group B,the SBP,DBP of group A were reduced（P〈0.05）before operation,puncturing,heating 1min,3min and over operation. The HR of group A was reduced（P〈0.05） before operation 、puncturing、heating 1 min,3 min and had not statistically significance（P〉0.05） over operation;The difference of SPO2 at the time point above had no statistically significance（P〉0.05）. Ramsy Rating：The Ramsy sedation scores of A group before operation,puncturing,heating 1 min,heating 3min and over operation were at level 0-2;Sedation scores of group B at each time point were at level 0. Conclusion：The sedative and anxiolytic effects of peroral Midazolam in thermocoagulation of elderly patients with trigeminal are significant.

关 键 词：三叉神经痛 射频温控热凝术 咪达唑仑 老年人 

分 类 号：R745.110.5[医药卫生—神经病学与精神病学]