摘要
目的观察咪唑安定伍用芬太尼在腰硬联合麻醉镇静临床效果。方法60例ASAⅠ—Ⅱ级妇科手术随机分为三组:Ⅰ组:芬太尼1μg/kg+咪唑安定0.03mg/kg;Ⅱ组:芬太尼1μg/kg+咪唑安定0.04mg/kg;Ⅲ组;芬太尼1μg/kg+咪唑安定0.05mg/kg。腰硬联合麻醉选择L2-3。腰麻药物先用0.75%盐酸布比卡因1.8ml,调整麻醉而至T8,手术开始前10min缓慢静注稀的镇静药合剂。观察5min,10min,30min,60min的OAA/S评分。记录病人遗忘情况。结果在给药后5minⅠ组OAA/S评分高于Ⅱ、Ⅲ组(P<0.05);在给药后10min,30min,60min,Ⅰ组OAA/S评分高于Ⅱ、Ⅲ组(P<0.05,P<0.01)表1。在给药30min,Ⅲ组遗忘作用优于Ⅰ组,在给药120MIN,Ⅲ组遗忘作用优于Ⅰ组(P<0.05)表2。结论Ⅲ组剂量合理,在腰硬联合麻醉镇静起效快,镇静遗忘效果强。
Objective To investigate the clinical effects of midazolam associated with fentanyl for sedation and amnesia during combined spinal-epidural analgesia. Methods sixty patients ASA physical status Ⅰ and Ⅱ undergoing gynecological operation were randomly divided into 3 grounds： Ground Ⅰ ： fentanyl 1μg/kg ＋midazolava 0.03mg/kg. Gound Ⅱ： fentanyl 1 μg/kg ＋midazolam 0.04mg/kg. Ground Ⅲ： fentanyl 1μg/kg＋midazolam 0.05mg/kg. 1.8ml of 0.5% bupivacaine was injected into the subaraehnoid space at the L3-L4 interspace, sensory block leve reached T8. patients received slowly intravenous midazolam and fentanyl 10 rain before operation. Level of sedation was assessed using observer＇s estimation of alertness/sedation （OAA/S） scale in 5 min, 30 rain, 60 min. Results OAA/S score in Ground Ⅰ was higher than that in Ground Ⅱ and Ground Ⅲ 10 min after intravenous sedative （P〈0.05）; OAA / S score in Ground Ⅰ was higher than that in Ground Ⅱ and Ground Ⅲ 10 min, 30min, 60min after intravenous sedative （P〈0.05 P〈0.01）, table 1. sedative in Ground Ⅲ has more obvious effect on amnesia than that in Group Ⅰ 30min and 120 rain after intravenous sedative （P〈 0.05） table 2. Conclusions sedative in Ground Ⅲ has obvious effect on amnesia and its effect was quick.
出处
《海南医学》
CAS
2007年第2期15-16,共2页
Hainan Medical Journal
关键词
眯唑安定
芬太尼
腰硬联合麻醉
镇静
midazolam
fentanyl
combined spinal-epidural analgesia
sedation
