布比卡因联合咪唑安定阻滞脊神经止痛效果观察

Intrathecal midazolam with bupivacaine in patients increases the analgesic effects of spinal blockade

目的:研究痔切除术后应用咪唑安定与布比卡因联合阻滞脊神经的止痛效果。方法:45例痔切除术后患者随机分为3组,每组15例,对照组鞘内注入0.5%布比卡因1mL与0.9%生理盐水0.2mL,咪唑安定Ⅰ组鞘内注入0.5%布比卡因1mL与1mg咪唑安定0.2mL,咪唑安定Ⅱ组鞘内注入0.5%布比卡因1mL与2mg咪唑安定0.4mL,比较3组术后止痛用药情况以及术后并发症发生率和恢复情况。结果:咪唑安定组止痛时间明显长于对照组(P<0.01),止痛药剂量明显少于对照组(P>0.05);咪唑安定Ⅱ组止痛时间明显长于Ⅰ组(P<0.05),止痛药剂量无明显差异(P<0.01)。术后每组各有3例患者发生尿潴留,对照组恶心/呕吐1例,对照组、咪唑安定I组、咪唑安定Ⅱ组自主排尿时间分别为(4.99±2.99)、(4.95±2.56)、(5.31±2.12)h。结论:咪唑安定与布比卡因联合阻滞脊神经可延长止痛时间,并与咪唑安定剂量有关。

Objective： In the present double-blind study we aimed to evaluate the analgesic effects of intrathecal midazolam with bupivacaine following haemorrhoidectomy.Methods： Forty-five patients were randomly allocated to one of three groups： the control group received 1 ml of 0.5% heavy bupivacaine plus 0.2 ml of 0.9% saline intrathecally,group BM1 received 1 ml of 0.5% bupivacaine plus 0.2 ml of 0.5% preservative-free midazolam and group BM2 received 1 ml of 0.5% bupivacaine plus 0.4 ml of 0.5% midazolam.Results：Time to first analgesia was significantly greater in the midazolam groups than in the placebo and significantly less in the BM1 group than in the BM2 group.Conclusions：Intrathecal midazolam with bupivacaine in patients increases the analgesic effects of spinal blockade,which correlates with dosage