摘要
目的比较右美托咪啶与咪达唑仑复合舒芬太尼用于肝癌微波治疗术患者麻醉的效果。方法择期行经皮肝穿刺微波治疗术的肝癌患者40例，男性，ASA分级Ⅱ级，年龄35～62岁，体重45～70kg，采用随机数字表法，将其随机分为2组（n=20）：咪达唑仑组（Ⅰ组）和右美托咪啶组（Ⅱ组）。Ⅰ组静脉注射咪达唑仑负荷量40μg／kg，然后静脉输注咪达唑仑40μg·kg^-1·h^-1；Ⅱ组静脉注射右美托咪啶负荷量1μg／kg，然后静脉输注右美托咪啶0．5μ·kg^-1·h^-1。两组药物负荷量均用生理盐水稀释至20ml，注射时间均为10min。负荷量注射完毕后5min时，静脉注射舒芬太尼负荷量0．2μg／ks，然后采用舒芬太尼行PCIA，背景输注速率0．1μg·kg^-1·h^-1，PCA量0．1μg/kg，锁定时间3min。舒芬太尼负荷量注射完毕后2min开始手术。记录术中心动过缓、心动过速、低血压、高血压和呼吸抑制的发生情况；记录舒芬太尼的PCA总按压次数和有效按压次数。结果两组心动过缓、心动过速、低血压和高血压的发生率比较差异无统计学意义（P〉0．05）；与Ⅰ组比较，Ⅱ组呼吸抑制发生率降低，舒芬太尼PCA总按压次数和有效按压次数减少（P〈0．05）。结论肝癌微波治疗术患者右美托眯啶复合舒芬太尼的麻醉效果优于咪达唑仑复合舒芬太尼。
Objective To compare the efficacy of anesthesia with dexmedetomidine and midazolam combined with sufentanil in patients undergoing microwave coagulation therapy for liver cancer. Methods Forty ASA Ⅱ male patients, aged 35-62 yr, weighing 45-70 kg, scheduled for percutaneous microwave coagulation therapy, were randomly divided into 2 groups （ n= 20 each） ： midazolam group （ group Ⅱ） and dexmedetomidine group （group Ⅱ ）. A loading dose of midazolam 40 μg/kg （in normal saline 20 ml） was given intravenously over 10 min, followed by midazulam infusion at 40 μg· kg^- 1· h ^- 1 in group Ⅰ . A loading dose of dexmedetomidine 1 μg/kg （ in normal saline 20 ml） was given intravenously over 10 min, followed by dexmedetomidine infusion at 0.5 μg· kg^- 1· h^- 1 in group Ⅱ . At 5 min after administration of the loading dose of midazolam or dexmedetomidine, a loading dose of sufentanil 0.2 μg/kg was given, and then patient-controlled intravenous anesthesia with snfentanil （background infusion 0. 1 μg·kg^-1 · h^-1, bolus dose 0.1 μg/kg, lockout interval 3 min） was used. The operation was started 2 mitt after administration of the loading dose of sufenianil. Bradycardia, tachycardia, hypotension, hypertensian and respiratory depression were recorded. The number of attempts and successfully delivered doses was also recorded. Results There was no significant difference in the incidence of bradycardia, tachycardia, hypotension and hypertension between the two groups （ P 〉 0.05）. The incidence of respiratory depression was significantly lower, and the number of attempts and successfully delivered doses was smaller in group Ⅱ than in group Ⅰ （ P 〈 0.05 ）. Conclusion The efficacy of anesthesia with dexmedetomidine and sufentanil is better than that of anesthesia with midazolam and sufentanil in patients undergoing microwave coagulation therapy for liver cancer.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2011年第6期664-666,共3页
Chinese Journal of Anesthesiology
基金
福建看卫生厅面向农村和城市社区推广适宜技术项目计划（200803）
