咪达唑仑复合瑞芬太尼用于女性乳腺手术患者无肌松气管插管的效果观察  

Effect of combined use of midazolam and remifentanil without muscle relaxants on tracheal intubation in female patients undergoing breast surgery

作　　者：付莉珺 刘祖莹 樊家鸣 谢艳乐 徐笑茵 樊肖冲[1] Fu Lijun;Liu Zuying;Fan Jiaming;Xie Yanle;Xu Xiaoyin;Fan Xiaochong(Department of Pain,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Anesthesia and Perioperative Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院疼痛科,郑州450052 [2]郑州大学第一附属医院围手术期医学麻醉科,郑州450052

出　　处：《中国基层医药》2024年第4期570-573,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的评价咪达唑仑复合瑞芬太尼用于女性乳腺手术患者无肌松气管插管的效果。方法研究对象为郑州大学第一附属医院2023年1—6月拟行气管插管全身麻醉的女性乳腺病患者40例。采用回顾性研究方法,根据插管时有无应用肌松药分为对照组(n=20)和观察组(n=20)。对照组静脉注射罗库溴铵,观察组不用肌松药。两组均静脉注射咪达唑仑0.1 mg/kg和瑞芬太尼4μg/kg后气管插管。按照置入喉镜难易、是否有咳嗽体动等方面对插管条件进行评价。结果两组患者年龄、身高和体质量差异均无统计学意义(均P>0.05)。观察组优秀率[45%(9/20)]低于对照组[85%(17/20)](χ^(2)=7.03,P=0.008);良好率[40%(8/20)]高于对照组[5%(1/20)](χ^(2)=7.03,P<0.05);观察组气管插管优良率为85%(17/20),与对照组的90%(18/20)比较,差异无统计学意义(χ^(2)=0.23,P>0.05)。观察组的术中知晓评分为(2.59±0.44)分,较对照组的(2.61±0.31)分差异无统计学意义(P>0.05)。两组术中未出现心律失常,术后未出现肌僵、恶心呕吐、皮肤瘙痒等不良反应。结论在无肌松药下,咪达唑仑0.1 mg/kg复合瑞芬太尼4μg/kg诱导女性乳腺手术患者气管插管可提供良好的气管插管条件,防止患者术中知晓发生。Objective To investigate the effect of combined use of midazolam and remifentanil without muscle relaxant on tracheal intubation in female patients undergoing breast surgery.Methods A retrospective analysis was performed on 40 female patients with breast disease who underwent tracheal intubation and general anesthesia at The First Affiliated Hospital of Zhengzhou University between January 2023 and June 2023.These patients were divided into a control group(n=20)and an observation group(n=20)based on whether muscle relaxants were applied at the time of intubation.The control group received intravenous rocuronium bromide,whereas the observation group did not use muscle relaxants.Both groups were intravenously administered midazolam(0.1 mg/kg)and remifentanil(4μg/kg)prior to tracheal intubation.The intubation conditions were evaluated based on factors such as the ease of inserting the laryngoscope and the patient's response to intubation,including coughing.Results There were no statistically significant differences in age,height,and body mass between the two groups(all P>0.05).The excellent rate of intubation conditions was significantly lower in the observation group compared with the control group[45%(9/20)vs.85%(17/20),χ^(2)=7.03,P=0.008].The good rate of intubation conditions was significantly higher in the observation group compared with the control group[40%(8/20)vs.5%(1/20),χ^(2)=7.03,P<0.05].There was no statistically significant difference in the excellent and good rates of intubation conditions between the observation and control groups[85%(17/20)vs.90%(18/20),χ^(2)=0.23,P>0.05].No significant difference in intraoperative awareness score was observed between the observation and control groups[(2.59±0.44)points vs.(2.61±0.31)points,P>0.05].None of the patients in either group exhibited any episodes of arrhythmias.Furthermore,no adverse reactions such as muscle stiffness,nausea,vomiting,or skin itching were observed in either group following the surgical procedure.Conclusion Without the use of muscle r

关 键 词：麻醉 全身 乳腺疾病 咪达唑仑 芬太尼 插管法 气管内 术中知晓 肌松弛药 中枢性 

分 类 号：R614[医药卫生—麻醉学]