静脉注射丁丙诺啡-咪唑安定用于硬膜外麻醉的临床观察

Clinical observation of intravenous buprenorphine-midazolam in supplement epidural anesthesia

目的:观察静脉注射丁丙诺啡-咪唑安定辅助硬膜外麻醉时的镇静、消除内脏牵拉反应效果和对呼吸、循环的影响。方法:硬膜外麻醉下行下腹部手术患者40例,随机分为B组20例(丁丙诺啡0.15mg+咪唑安定4mg)和F组20例(芬太尼0.1mg+咪唑安定4mg);均于手术开始前5min分别静脉缓慢注射上述药物剂量的3/4或全量。观察并记录用药时和用药后5,15,30min平均动脉压、心率、脉搏、血氧饱和度、呼吸频率及患者镇静程度和术中发生的牵拉反应。结果:B组的镇静、消除内脏牵拉反应的作用明显强于F组(P<0.05);两组对循环及呼吸均无明显影响(P>0.05)。结论:丁丙诺啡-咪唑安定能安全地辅助于硬膜外麻醉,能有效的增强镇静和消除内脏牵拉反应,对呼吸和循环无明显影响。

Objective To investigate the sedative, preventive effects against entrails pain and the influence of circulation and respiratory of intravenous administration of buprenorphine-midazolam in patients under epidural anesthesia. Methods Forty patients undergoing abdominal surgery were divided randomly into two groups （n=20）. Group B received 0. 15 mg buprenorphine ＋ 4 mg midazolam; Group F received 0.1 mg fantanyl ＋ 4 mg midazolam. All the drugs or 3/4 of the dose were intravenously injected 5 minutes before skin incision. The blood pressure, heart rate, SpO2 and respiratory frequency were monitored. The degree of sedation and the entrails pain were recorded during the operation. Results Group B was significant better in sedative action, decreasing entrails pain than group F （P 〈0. 05）. Both two groups had no significant influence on circulation and respiratory （P〉0. 05）. Conclusion Buprenorphine-midazolam can increase sedative action, decrease entrails pain, and does not significantly influence circulation and respiratory under epidural anesthesia. It can be safely used in epidural anesthesia.