咪达唑仑复合芬太尼用于臂丛神经阻滞的临床观察

Clinical Observation of Midazolam Combined with Fentanyl in Branchial Plexus Block

目的:探讨在臂丛神经阻滞下不同剂量咪达唑仑复合芬太尼对患者的镇静遗忘作用。方法:选取90例拟行单侧上肢手术的患者随机分成3组:Ⅰ组,咪达唑仑0.04mg·kg-1+芬太尼1μg·kg-1;Ⅱ组,咪达唑仑0.06mg·kg-1+芬太尼1μg·kg-1;Ⅲ组为对照组,穿刺前不给予任何药物。比较3组穿刺后的血压、心率、脉搏氧饱和度的变化、镇静程度和遗忘程度。结果:Ⅰ、Ⅱ组在不同时间的镇静程度均优于Ⅲ组(P<0.05),Ⅱ组在给药后30、120min遗忘程度优于Ⅰ组(P<0.05)。3组患者的术中生命体征无显著性变化(P>0.05)。结论:咪达唑仑复合芬太尼在臂丛神经阻滞下对患者可产生有效的镇静遗忘作用,提高麻醉质量和患者满意度。

OBJECTIVE： To probe into the effects of different doses of midazolam combined with fentanyl on anterograde amnesia in patients with branchial plexus block. METHODS： 90 patients to do one side upper limb operation were randomly divided into 3 groups, i.e. groupⅠ ,group Ⅱ and group Ⅲ, group Ⅰ was treated with midazolam 0.04 mg·kg^-1 and fentanyl 1 μg·kg^-1; group Ⅱ midazolam 0.06 mg·kg^-1 and fentanyl 1 mg·kg^-1 ;group Ⅲ, as control group, did not receive any treatment before puncture. The change of BP, HR and SpO2 and level of sedation and amnesia were compared among three groups. RESULTS： The levels of sedation at different time points in group Ⅰand group Ⅱ were both better than in groupⅢ （P〈0.05）. The levels of amnesia in group Ⅱ were superior to group Ⅰ at 30 min or 120 min after medication （P〈0.05）. Intraoperative vital signs of patients in three groups had no significant change （P〈0.05）. CONCLUSION： Midazolam combined with fentanyl have active effect to anterograde amnesia in patients with branchial plexus block. Consequently the quality of anaesthesia and patients＇ degree of satisfaction are improve.