咪达唑仑、地佐辛复合瑞芬太尼在肝癌患者射频消融术中的应用效果观察

Application Effects of Midazolam and Dezocine Combined with Remifentanil in Radiofrequency Ablation in Patients with Liver Cancer

目的:比较咪达唑仑、地佐辛复合瑞芬太尼在肝癌患者射频消融术中的应用效果。方法:选取2019年12月至2022年12月该院收治的行射频消融术的肝癌患者97例,按随机数字表法分为咪达唑仑组[咪达唑仑负荷量0.05 mg/kg+瑞芬太尼0.05μg/(kg·min)]48例和地佐辛组[地佐辛负荷量0.8 mg/kg+瑞芬太尼0.05μg/(kg·min)]49例。比较两组患者在入室时(T_(0))、消融开始时(T_(1))、消融开始后10 min(T_(2))和术毕时(T_(3))时的心率(HR)、血氧饱和度(SpO_(2))和平均动脉压(MAP);记录术中体动、呼吸抑制和心动过缓等发生情况;比较两组患者T_(1)、T_(2)和T_(3)时的Ramsay镇静评分,术毕、术后2 h和术后4 h的疼痛视觉模拟评分(VAS);记录两组患者术后不良反应发生情况。结果:两组患者T_(1)、T_(2)和T_(3)时的HR、MAP和SpO_(2)水平,Ramsay镇静评分的差异均无统计学意义(P>0.05)。地佐辛组患者术中并发症发生率为4.08%(2/49),低于咪达唑仑组的16.67%(8/48),差异有统计学意义(P<0.05);地佐辛组患者术后2、4 h时的VAS评分显著低于咪达唑仑组,差异均有统计学意义(P<0.05)。地佐辛组、咪达唑仑组患者术后不良反应总发生率分别为6.12%(3/49)、10.42%(5/48),差异无统计学意义(P>0.05)。结论:肝癌射频消融术中咪达唑仑、地佐辛联合瑞芬太尼均可实现良好的清醒镇痛;地佐辛可以进一步降低术中并发症发生率,减轻触发痛觉过敏。

OBJECTIVE:To compare the application effects between midazolam and dezocine combined with remifentanil in radiofrequency ablation in patients with liver cancer.METHODS:A total of 97 patients with liver cancer underwent radiofrequency ablation admitted into the hospital from Dec.2019 to Dec.2022 were selected to be divided into 48 cases in the midazolam group[given midazolam load 0.05 mg/kg+remifentanil 0.05μg/(kg·min)]and 49 cases in the dezocine group[dezocine load 0.8 mg/kg+remifentanil 0.05μg/(kg·min)].The heart rate(HR),oxygen saturation(SpO 2)and mean arterial pressure(MAP)were compared between two groups at the time of admission to the room(T 0),the time of ablation beginning(T 1),10 min after ablation beginning(T 2)and the end of surgery(T 3);the occurrences of body movement,respiratory depression and bradycardia during surgery were recorded;the Ramsay sedation scores at T 1,T 2 and T 3,the visual analog scale(VAS)at the end of surgery,2 h and 4 h after surgery were compared between two groups;the incidences of post-operative adverse drug reactions of both groups were recorded.RESULTS:There were no statistically significant differences in comparisons of HR,MAP,SpO 2 and Ramsay sedation scores at T 1,T 2 and T 3 between two groups(P>0.05).The incidence of complications of the dezocine group was 4.08%(2/49),lower than 16.67%(8/48)of the midazolam group,with statistically significant difference(P<0.05).The VAS scores at 2 h and 4 h after surgery were significantly lower in the dezocine group than those in the midazolam group,with statistically significant differences(P<0.05).The total incidences of adverse drug reactions of the dezocine group and the midazolam group were respectively 6.12%(3/49)and 10.42%(5/48),the difference was not statistically significant(P>0.05).CONCLUSIONS:Both midazolam and dizocine combined with remifentanil in radiofrequency ablation of liver function can achieve significant conscious analgesia,and dizocine can further reduce the incidence of intraoperative complications and alleviate triggered hyperpathia.