地佐辛伍用咪达唑仑辅助椎管内麻醉的镇静效果观察

Effect of dezocine combined with midazolam on sedation in assisted intraspinal anesthesia

目的:观察地佐辛伍用咪达唑仑辅助椎管内麻醉的镇静效果。方法:60例ASAⅠ~Ⅱ级的择期下腹部手术患者,随机分为2组,Ⅰ组地佐辛、咪达唑仑合剂组,Ⅱ组芬太尼、咪达唑仑合剂组,每组30例。硬膜外穿刺均采用L2~3间隙,于麻醉平面稳定后,I组静脉注射地佐辛0.1 mg·kg-1,咪达唑仑0.03 mg·kg-1;Ⅱ组静脉注射芬太尼0.01 mg·kg-1、咪达唑仑0.03mg·kg-1。用Ramesay评定镇静程度。结果:2组患者性别、年龄、体质量、手术时间无统计学差异。镇静效果注药后5,60min时2组差异有统计学意义(P<0.05)。术中血压、脉搏、血氧饱和度维持在安全范围。结论:地佐辛伍用咪达唑仑合剂较芬太尼伍用咪达唑仑合剂具有镇静遗忘作用强,对呼吸系统和血流动力学的影响较小,作为椎管内麻醉的辅助用药,它是可行的镇静镇痛的方法。

OBJECTIVE To observe the effect of dezocine combined with midazolam on sedation in assisted intraspinal anes thesia. METHODS 60 ASA I - lI patients undergoing elective abdominal operation, were randomized equally into two groups： dezocine combined with midazolam group（group I ）, fentanyl combined with midazolam group （group ]][ ）. Lumbar puncture was performed at the L2 - 3 interspace. When the level of anesthesia was stabilized after anesthesia, group I intravenous dezo- cine 0. 1 mg.kg ~, midazolam 0. 03 mg.kg ~ ; group[[ intravenous fentanyl 0. 01 mg-kg ~, midazolam 0. 03 mg.kg ~. The Ramesay was used to assess the degree of sedation. RESULTS There was no statistically difference between the two groups of gender, age, body weight, operation time. The sedative effect at 5,60 min after intravenous between the two groups was statis- tically significant （P^0. 05）. Blood pressure, pulse, oxygen saturation during operation maintained in a safe range. CONCLU- SION Dezocine combined with midazolam produced satisfactory sedation and amnesia and little effect on the respiratory and hemodynamic. It is a feasible method of sedation and analgesia for spinal anesthesia.