摘要
目的 探讨芬太尼复合咪达唑仑辅助颈丛神经阻滞在甲状腺手术中的效果.方法 分析我院2010年2月~2013年4月收治的甲状腺腺瘤或结节性甲状腺肿患者62例,按照随机数字表法分成治疗组32例与对照组30例,对照组给予芬太尼,治疗组在对照组的基础上加用咪达唑仑.比较两组动脉压、心率、脉搏氧饱和度、疼痛程度（VAS）、血浆肾上腺素（E）、内皮素（ET）、血管紧张素-Ⅱ（Ang-Ⅱ）水平的变化,评价术中疼痛及呼吸抑制、肌强直等不良反应的情况.结果 ①治疗组与对照组T1、T2、T3时段MAP、HR、SpO2比较,有显著差异（P ＜0.05）.两组HR T4时段比较有显著性差异（P ＜0.05）.②治疗组与对照组切皮时、分离峡部时VAS评分比较有显著性差异（P ＜0.05）.③治疗组T1、T2、T3时段E、ET、Ang-Ⅱ值与对照组比较,有显著性差异（P ＜0.05）.E、ET在T4时段治疗组与对照组比较,有显著性差异（P＜0.05）.结论 芬太尼复合咪达唑仑辅助颈丛神经阻滞在甲状腺手术中镇静、镇痛效果确切,血流动力学稳定,适合手术要求.
Objective To explore the effect of fentanyl and midazolam assisted cervical plexus nerve block on thyroid operation anesthesia. Methods Thyroid adenoma or nodular goiter patients （62 cases） in our hospital from 2010 February to 2013 April were analyzed and randomly divided into the treatment group（32 cases）and control group （30 cases）. The control group patients were treated by fentanyl and the treatment group patients were treated by midazolam on the basis of the control group. The changes of arterial blood pressure, heart rate, pulse oxygen saturation, the degree of pain （VAS）, plasma epinephrine（E）, endothelin （ET）, angiotensin II （Ang - II ） level were compared.Adverse reaction of pain and respiratory inhibition, myotonia during operation were evaluated. Rusults ①The comparison of MAP, HR, SpO2 on T1, T2, T3 period between two groups were statistically significant（P〈0.05）. The comparison of HR on T4 between two groups was statistically significant（P〈0.05）. ②The comparisons of VAS of skin incision, isthmus separation between two groups were statistically significant （P〈0.05）. ③ The comparisons of E,ET,Ang- II on T1, T2, T3 period between two groups were statistically significant （P〈0.05）. The comparisons of E,ET on T4 period between two groups were statistically significant（P〈0.05）. Conclusion Analgesic effect of fentanyl combined with midazolam assisted cervical plexus block in thyroid operation has exact sedation.The hemodynamic of patients is stability. Fentanyl and midazolam assisted cervical plexus nerve block on thyroid operation anesthesia is suitable for the operation requirement.
出处
《中国现代医生》
2014年第3期72-74,共3页
China Modern Doctor
