不同剂量咪达唑仑辅助子宫下段剖宫产术硬膜外麻醉的效果及安全性分析  

Effectiveness and Safety Analysis of Epidural Anesthesia for Lower Uterine Segment Cesarean Delivery Assisted by Different Doses of Midazolam

作　　者：白姗 张明新 Bai Shan;Zhang Mingxin(Anesthesia Operating Room,Chinese Medicine Hospital Affiliated to Nanyang Higher Medical College,Nanyang,Henan,473000,China)

机构地区：[1]南阳市医学高等专科学校附属中医院麻醉手术室,河南南阳473000

出　　处：《黑龙江医学》2024年第7期791-793,797,共4页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关项目(2021002162)。

摘　　要：目的:观察不同剂量咪达唑仑对子宫下段剖宫产术硬膜外麻醉的效果及安全性。方法:选取2021年3月—2022年6月于南阳市医学高等专科学校附属中医院行子宫下段剖宫产术的120例产妇作为研究对象,采用抽签法分为观察组和对照组,每组各60例。两组产妇术中均实施硬膜外麻醉,对照组产妇予以常规剂量咪达唑仑辅助麻醉,观察组产妇予以小剂量咪达唑仑辅助麻醉,比较两组产妇的术中、术后镇痛效果,术前、术后微循环功能,术后苏醒质量及不良事件发生情况。结果:术后,观察组产妇的血氧饱和度(SaO_(2))、动脉氧分压(PO_(2))高于对照组,动脉二氧化碳分压(PaCO_(2))低于对照组,差异有统计学意义(t=3.030、2.897、3.353,P<0.05);不同麻醉方案下,观察组产妇苏醒时间低于对照组,差异有统计学意义(t=5.205,P<0.05);不同麻醉方案下,观察组产妇苏醒后不良事件发生率低于对照组,差异有统计学意义(χ^(2)=7.048,P<0.05)。结论:不同剂量咪达唑仑辅助硬膜外麻醉对子宫下段剖宫产术产妇的术中、术后镇痛效果均较为显著,均不会对患者苏醒质量产生明显影响,但相比之下,小剂量咪达唑仑可缩短患者术后苏醒时间、对患者微循环功能产生的影响更小,术后不良事件发生风险更低。Objective:To observe the effect and safety of different doses of midazolam on epidural anesthesia for lower uterine segment cesarean delivery.Methods:120 cases of women who underwent lower uterine segment cesarean section treatment in the hospital from March 2021 to June 2022 were selected as the study subjects,and were divided into the observation group and the control group with the lottery method,with 60 cases in each group.Epidural anesthesia was implemented in both groups,the control group was assisted with regular dose of midazolam,and the observation group was assisted with small dose of midazolam.The intraoperative and postoperative analgesic effects,preoperative and postoperative microcirculatory function,postoperative awakening quality and the occurrence of adverse events were compared between the two groups.Results:Postoperatively,the blood oxygen saturation(SaO_(2))and arterial partial pressure of oxygen(PO_(2))of the observation group were higher than those of the control group,and the arterial partial pressure of carbon dioxide(PaCO_(2))was lower than those of the control group,and the differences were statistically significant(t=3.030,2.897,3.353;P<0.05).Under different anesthesia regimens,the awakening time of the observation group was lower than that of the control group,and the difference was statistically significant(t=5.205,P<0.05).Under different anesthesia regimens,the incidence of adverse events after awakening in the observation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=7.048,P<0.05).Conclusion:Different doses of midazolam-assisted epidural anesthesia have significant intraoperative and postoperative analgesic effects on women undergoing cesarean section in the lower uterine segment,and none of them significantly affects the quality of patients’awakening.However,in comparison,a small dose of midazolam can shorten patients’postoperative awakening time,have less impact on patients’microcirculatory function,and have lower risk

关 键 词：子宫下段剖宫产 咪达唑仑 硬膜外麻醉 镇痛效果 麻醉安全性 

分 类 号：R614[医药卫生—麻醉学]