摘要
目的探讨不同配伍清醒镇静镇痛在妇科腹腔镜手术中应用的安全性、有效性。方法抽取60例择期妇科腹腔镜手术患者，全部病例麻醉方法为连续硬膜外阻滞复合清醒镇静镇痛，根据不同清醒镇静镇痛配伍随机分为3组，每组20例，布托啡诺和咪唑安定组（B组），芬太尼和咪唑安定组（F组），芬太尼和丙泊酚组（P组）。记录诱导前（T1）、诱导后即时（T2）、手术开始时（T3）、术中30min（T4）、术毕（T5）5个时点MAP、SpO2、HR、RR，观察术中呼吸抑制及不自主体动，应用警觉-镇静（OAA／S）评分和镇痛分级评价镇痛镇静效果，并进行对比分析。结果①B、F两组与P组比较在T2、T3两个时点生命体征有显著差异，B、F两组血流动力学、呼吸参数较P组稳定，呼吸抑制发生率低，其中B组改变最小，B、F两组间比较无显著差异。②B、F两组术中、术后合作能力好，术后苏醒时间短，B、F两组间无显著差异，较P组差异显著。结论硬膜外麻醉复合清醒镇静镇痛用于在妇科腹腔镜手术中镇痛完善，麻醉管理方便，安全有效，布托啡诺伍用咪唑安定其安全性、有效性更具优势。
Objective To study the safety and efficiency of different compatibility conscious sedation and analgesia. Methods To chose 60 cases to using in gynecology three groups, each have twenty, Butorphanol and. midazolam in group B, Fentanyl and midazolam in group F, Propofol and fentanyl in group P, RecodeMAP, SPO2 , HR, RR, to observed the respiration restrain and body moving in operation time, using OAA/S and analgesia graded estimate the effect of sedation and analgesia, then contrast it. Results （1） SPO2, RR have statistics difference between group B, F and group P, group B, F are more stabilization than group P. （2）The awake time and body moving in group B, F are also shorter and much less than group P, between them have notabitity difference. Conclusion Conscious sedation and analgesia can using in gynecology operation safety, group B is the best.
