咪达唑仑和氟哌利多在硬膜外麻醉术中的疗效对比

The effects comparison of midazolam and droperidol on epidural anesthesia

目的比较咪达唑仑和氟哌利多在硬膜外麻醉术中的疗效。方法选择我院在硬膜外麻醉下行下肢或中下腹部手术的患者82例,随机分为咪达唑仑组(M组)和氟哌利多组(D组),硬膜外麻醉后分别给予静脉注射咪达唑仑0.04mg/kg和氟哌利多0.05mg/kg。比较两组血流动力学参数、呼吸、动脉血氧饱和度、镇静程度、术后遗忘及其他不良反应的发生率。结果与用药前比较,用药后两组患者MAP、HR、RR、SpO2均有不同程度的降低,T1(用药后5min)时MAP、HR、RR及SpO2最低,差异均有统计学意义(P<0.05);与D组比较,两组在各时间点上差异无统计学意义(P>0.05)。用药后两组OAA/S评分较用药前明显降低,差异有统计学意义(P<0.05),两组间在各时间点上差异无统计学意义(P>0.05)。M组完全遗忘、不全遗忘及无遗忘的发生率分别为78%、17.1%和4.9%,D组分别为12.2%、19.5%和68.3%。M组完全遗忘率显著高于D组,差异有统计学意义(P<0.01)。结论咪达唑仑和氟哌利多均为用于硬膜外麻醉中安全有效的镇静药,但咪达唑仑独特的顺行性遗忘作用明显减少患者对手术的痛苦感受,其效果优于氟哌利多。

Objective To compare the effects of midazolam and droperidol on epidural anesthesia.Methods A total of 82 patients requiring epidural anesthesia were randomly assigned to two groups to receive midazolam group M or droperidol guoup D.After epidural anesthesia performed,midazolam（0.04mg/kg）and droperidol（0.05mg/kg） were injected intravenously in each group respectively.Comparison of two groups of parameters of hemodynamics,respiratory,arterial oxygen saturation,the degree of sedation,amnesia after operation and the incidence of adverse reactions.Results Compared with that before treatment,after treatment in two groups of patients with MAP,HR,RR,SpO2 were decreased in different dagree.T1（5 minutes after administration）MAP,HR,RR and SpO2 were minimun.Three were significant differences（P 〈0.05）.Compared with D group,the two groups at each time point,the difference was not statistically significant（P 〉0.05）.After administration of two groups of OAA/S score than before treatment was significantly lower,the difference was statistically significant（P 〈0.05）,between the two groups at each time point were no statistical difference（P 〉0.05）.Group M completely forgotten,not completely forgotten and no forgetting rate were 78%,17.1% and 4.9%,group D were 12.2%,19.5% and 68.3%.The group M was significant higher than group D in completely forgotten,the difference was statistically significant（P 〈0.01）.Conclusion Midazolam and droperidol were used for epidural anesthesia is safe and effective sedation.But midazolam unique anterograde amnesia for the operation was significantly less in patients with painful feelings,better than the effect of droperidol.