咪达唑仑联合芬太尼对腹腔镜卵巢囊肿切除术患者应激反应及血流动力学的影响  

Effects of midazolam combined with fentanyl on stress response and hemodynamics in patients undergoing laparoscopic ovarian cyst resection

作　　者：魏军 Wei Jun(Department of Anesthesiology,Pingqiao Maternal and Child Health Hospital,Xinyang 464000,Henan,China)

机构地区：[1]信阳市平桥区妇幼保健院麻醉科,河南信阳464000

出　　处：《四川生理科学杂志》2025年第3期641-644,共4页

摘　　要：目的:探究咪达唑仑(Midazolam,MDZ)联合芬太尼对腹腔镜卵巢囊肿切除术(Laparoscopic ovarian cyst resection,LOCR)患者应激反应及血流动力学的影响。方法:选取2022年8月~2024年6月期间于本院接受LOCR治疗的94例卵巢囊肿患者作为研究对象,按随机数字表法将患者分为对照组和观察组,各47例。对照组接受芬太尼麻醉,观察组接受MDZ联合芬太尼麻醉。分析对比两组的血流动力学指标[平均动脉压(Mean arterial pressure,MAP)、心率(Heart rate,HR)]、疼痛程度[视觉模拟评分法(Visual analogue scales,VAS)评分]、镇静效果、应激反应[谷胱甘肽过氧化物酶(Glutathione peroxidase,GSH-Px)、总抗氧化态(Total antioxidant status,TAS)、过氧化氢(Hydrogen peroxide,H_(2)O_(2))]水平以及并发症发生率。结果:两组镇静后、苏醒即刻的MAP、HR水平均比用药前明显降低,但观察组明显较对照组高(P<0.05)。术后6 h、12 h、24 h,观察组的VAS评分均明显比对照组低(P<0.05)。观察组的镇静优良率明显高于对照组(P<0.05)。术后12 h,两组血清GSH-Px、TAS水平均明显降低,但观察组明显较对照组高(P<0.05);两组H_(2)O_(2)水平均明显升高(P<0.05),但观察组明显较对照组低(P<0.05)。两组并发症发生率无明显差异(P>0.05)。结论:MDZ联合芬太尼应用于LOCR患者,可提升镇静效果,减轻疼痛感,减少对机体血流动力学及应激反应的影响,且安全性较高。Objective:To investigate the effects of midazolam(MDZ)combined with fentanyl on stress response and hemodynamics in ovarian cyst patients undergoing laparoscopic ovarian cyst resection(LOCR).Methods:Ninety-four patients who underwent LOCR treatment in our hospital between August 2022 and June 2024 were selected.The patients were divided into the control group(performing fentanyl anesthesia,47 cases)and the observation group(performing MDZ combined with fentanyl anesthesia,47 cases)according to the random number table method.The hemodynamic levels[mean arterial pressure(MAP),heart rate(HR)],pain level[Visual analogue scales(VAS)score],sedation effect,stress response[glutathione peroxidase(GSH-Px),total antioxidant status,(TAS),hydrogen peroxide(H_(2)O_(2))]levels,and the rate of complications were analyzed and compared between the two groups.Results:After sedation and immediately upon awakening,the levels of MAP and HR in both groups were significantly lower than before medication,but were notably higher in the observation group compared to the control group(P<0.05).At 6 hours,12 hours and 24 hours,post-operation,the VAS scores in the observation group were significantly lower than those in the control group(P<0.05).The rate of excellent sedation in the observation group was significantly higher than in the control group(P<0.05).At 12 hours post-operation,serum levels of GSH-Px and TAS in both groups were significantly reduced,but were notably higher in the observation group compared to the control group(P<0.05).The levels of H_(2)O_(2) in both groups were significantly increased(P<0.05),but were notably lower in the observation group compared to the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:MDZ combined with fentanyl in patients with LOCR can improve sedation,relieve pain,reduce the impact on the body's hemodynamics and stress response,with high safety.

关 键 词：咪达唑仑 腹腔镜卵巢囊肿切除术 芬太尼 血流动力学 应激反应 

分 类 号：R61[医药卫生—外科学]