小剂量咪唑安定辅助硬膜外麻醉对患者镇静与遗忘作用的临床观察

Sedative and Amnestic Effect of Low Dosage of Midazolam in Epidural Anesthesia

目的观察小剂量咪唑安定辅助硬膜外麻醉镇静效果及遗忘的作用.方法硬膜外麻醉下行下腹部手术60例,ASAI～Ⅱ级,随机分成A、B两组(A:实验组;B:对照组).A组入室后硬膜外穿刺前5min咪唑安定0.05mg/kg静脉注射;B组给0.9%生理盐水2mL静脉注射.采用Ramsay镇静评分,记录BP、HR、RR、SpO2等的变化,术后24h随访患者,评价患者对麻醉操作及手术操作的遗忘程度.结果两组患者用药前后BP、HR、RR、SpO2无统计学意义(P>0.05),均在正常范围之内.A组对麻醉及手术操作的完全遗忘率为30%、97%,不全遗忘率为17%、3%.而B组麻醉穿刺完全遗忘率为0%、手术操作完全遗忘率10%.两组比较差异有显著性(P<0.05).结论硬膜外穿刺前5min静脉注射咪唑安定0.05mg/kg,可使患者消除焦虑、恐惧心理,既安静又能配合麻醉和手术体位,对麻醉和手术操作有很好的镇静和记忆遗忘作用.

Objective To observe the sedative and amnestic effect of low dosage of midazolam in epidural anesthesia.Methods Sixty ASA I～II patients who received abdomen operation after epidural anesthesia were randomly divided into two groups：A group and B group.Patients in A group were given intravenous injection of 0.05 mg/kg of midazolam 5 mins before epidural anesthesia,and patients in B group received intravenous injection of 2 ml of 0.9% normal saline solution.Ramsay was used to evaluate the sedative effects of patients,BP,HR,RR,and SpO2 were recorded during operation.All patients were followed up for 24 hours after operation,and the amnestic effect of midazolam on patients to anesthesia and operation was evaluated.Results BP,HR,RR,and SpO2 of patients in both groups were in normal levels,and there was no statistical difference between the two groups（P〉0.05）.In A group the complete amnestic rate of patients to anesthesia and operation was 30% and 97%,and the incomplete amnestic rate was 17% and 3% .While in B group,the complete amnestic rate of patients to anesthesia and operation was 0% and 10%,there was statistical difference between the two groups（P〈0.05）.Conclusions Intravenous injection of 0.05 mg/kg of midazolam 5 mins before epidural anesthesia can make patients be free from anxiety and fear for operation.Midazolam has good sedative and amnestic effect on patients in anesthesia and operation.