咪达唑仑复合芬太尼在阑尾切除术硬膜外麻醉中的临床应用效果分析  

Clinical effect of midazolam combined with fentanyl in epidural anesthesia for appendectomy

作　　者：李阳洋 LI Yangyang(The Second Department of Surgery Anesthesia, Nanyang Central Hospital Nanyang, Henan 473000, China)

机构地区：[1]河南省南阳市中心医院手麻2部,河南南阳473000

出　　处：《中国医学工程》2018年第10期42-44,共3页China Medical Engineering

摘　　要：目的分析咪达唑仑复合芬太尼在阑尾切除术连续硬脊膜外阻滞麻醉(硬膜外麻醉)中的临床应用效果。方法选取2017年3月-2018年3月该院收治的阑尾炎手术患者64例,使用随机数字表法分为两组。对照组32例给予丙泊酚麻醉,观察组32例给予咪达唑仑复合芬太尼硬膜外麻醉。对比两组患者镇静效果、牵拉反应及不良反应发生情况。结果观察组镇静起效时间(5.30±1.10)min、镇静持续时间(3.51±0.28)h,均明显优于对照组的(10.42±2.89)min、(2.12±0.40)h,比较差异有统计学意义(P <0.05);观察组牵拉反应情况优于对照组,差异有统计学意义(P <0.05);两组心率加快、头痛、恶心呕吐及呼吸抑制等不良反应发生情况比较,差异无统计学意义(P>0.05)。结论咪达唑仑复合芬太尼在阑尾切除术硬膜外麻醉中能够取得显著镇静效果,有效缓解内脏牵拉反应,安全性较高。【Objective】To analyze the clinical effect of midazolam combined with fentanyl in epidural anesthesia for appendectomy.【Methods】Sixty-four cases of appendicitis surgery in our hospital from March 2017 to March 2018 were selected and divided into two groups by random number table. In the control group, 32 patients were given propofol anesthesia, and the other 32 cases in the observation group were given midazolam combined with fentanyl epidural anesthesia. The sedation effect, traction reaction and adverse reactions were compared between the two groups.【Results】The sedative onset time [（5.30±1.10） min] and sedative duration [（3.51±0.28） h] of the observation group were significantly better than those of the control group [（10.42±2.89） min and（2.12±0.40） h]（P〈0.05）, and the distraction reaction in the observation group was better than that in the control group with statistically significant（P〈0.05）. There was no significant difference in the incidence of heart rate, headache, nausea and vomiting, respiratory depression and other adverse reactions between the two groups（P〈0.05）.【Conclusion】The midazolam combined with fentanyl can achieve significant sedative effect in the epidural anesthesia of appendectomy, effectively relieving the visceral traction reaction with high safety.

关 键 词：咪达唑仑 芬太尼 丙泊酚 镇静效果 内脏牵拉反应 

分 类 号：R656.8[医药卫生—外科学] R614[医药卫生—临床医学]