麻醉诱导前给予咪达唑仑在甲状腺癌根治术中的麻醉效果及对苏醒质量的影响  

Anesthetic Effect of Midazolam and Its effect on Palinesthesia Quality in Patients Undergoing Radical Operation for Thyroid Cancer before Anesthesia Induction

作　　者：王红运[1] 高臻辉[1] 薛晓玲[2] 

机构地区：[1]宝鸡市中心医院麻醉科,陕西宝鸡721008 [2]宝鸡市妇幼保健院妇科,陕西宝鸡721008

出　　处：《解放军医药杂志》2017年第5期101-104,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：西部地区妇幼卫生能力提升项目(2015FYQ003)

摘　　要：目的观察咪达唑仑对全凭静脉麻醉下甲状腺癌根治术患者麻醉效果及苏醒质量的影响。方法研究对象选取宝鸡市中心医院于2015年2月—2016年5月接受甲状腺癌根治术的患者102例,根据麻醉诱导给药不同分为对照组和观察组,每组51例。对照组分别静脉注射丙泊酚、舒芬太尼及注射用顺苯磺阿曲库铵进行麻醉诱导,观察组则在麻醉诱导前静脉注射咪达唑仑,并在手术结束时静脉注射氟马西尼。采用脑电双频指数(bispectral index,BIS)评价麻醉效果,比较两组术前及术中各时间点BIS,同时比较各项苏醒质量指标、丙泊酚和瑞芬太尼总用量、围术期认知功能评分和并发症发生率。结果观察组在诱导后3 min、气管插管时和诱导后1 h的BIS均明显低于对照组(P<0.01),拔管时间、呼唤睁眼时间、丙泊酚和瑞芬太尼总用量均明显低于对照组(P<0.01),在术后24 h的简易精神状态量表评分和总并发症发生率也明显低于对照组(P<0.01)。结论麻醉诱导前静脉注射咪达唑仑能提高全凭静脉麻醉在甲状腺癌根治术中的麻醉效果,维持麻醉深度,并有效减少麻醉药物使用剂量和并发症。Objective To observe effects of Midazolam on anesthesia effect and palinesthesia quality of patients undergoing radical operation for thyroid cancer under intravenous anesthesia. Methods A total of 102 patients undergoing radical operation for thyroid cancer during February 2015 and May 2016 were divided into control group and observation group （n = 51 for each group）. Control group received intravenous anesthesia with Propofol, Sufentanil and Cisatracurium Besilate respectively, while observation group was intravenously injected Midazolam before anesthesia induction and Flumazeni at the end of surgery. In two groups, bispectral indexes （BIS） were used to evaluate anesthesia effect; BIS values before and at different times during operation were compared ; values of recovery quality indicators, total dos- age of Propofol and Remifentanil, perioperative cognitive function scores and incidence rate of complications were com- pared. Results Compared with those in control group, in observation group, BIS values at 3min after induction, at the time of tracheal cannula and lh after induction were significantly lower （P 〈 0. 01 ） ; values of extubation time, calling and eyes opening time, the total dosage of Propofol and Remifentanil were also significantly lower （P 〈 0. 01 ） ; postoperative 24h mini-mental state examination （MMSE） score and the total incidence rate of complications were significantly lower （P 〈 0. 01 ）. Conclusion Intravenous injection of Midazolam before anesthesia induction can increase anesthesia effect of patients undergoing radical operation for thyroid cancer under intravenous anesthesia, maintain the anesthesia depth and effectively reduce anesthetic dosage and incidence rate of complications.

关 键 词：甲状腺肿瘤 咪达唑仑 麻醉 静脉 甲状腺癌根治术 

分 类 号：R614.24[医药卫生—麻醉学] R736.1[医药卫生—外科学]