咪达唑仑联合瑞芬太尼在睑袋成形术麻醉中的应用

Efficacy of midazolam combined with remifentanil for lower eyelid blephamoplasty

目的评价咪达唑仑联合瑞芬太尼在睑袋成形术麻醉中的应用效果。方法200例睑袋成形术者，随机分为实验组和对照组（每组100例）。采用双盲法，实验组给予0．05mg／kg咪达唑仑和0．51μg／kg瑞芬太尼诱导．推注时间〉90s。随后用瑞芬太尼0．05μg／（kg·min）持续静脉泵注。对照组给予0．05mg／kg咪达唑仑。并记录给药前、给药后3min、手术开始时、术中、术毕、术后30min的平均动脉压（MAP）、心率（HR）、呼吸（RR）、脉搏氧饱和度（SpO2）的变化；手术时间、苏醒时间、术中术后不良反应发生率及受术者和手术医师的满意度等。结果两组患者术中平均MAP、HR、RR、SpO2及术后苏醒时间差异无统计学意义（P〉0．05）；实验组术后恶心、呕吐发生率明屁高于对照组（P〈0．05）；实验组受术者和医师满意度明显高于对照组[（91．3±11．6）比（52．7±10．4），P〈0．05]。结论咪达唑仑联合瑞芬太尼用于睑袋成形术麻醉，术中呼吸循环稳定。受术者和医师满意度高。但诱导阶段有呼吸抑制，苏醒阶段有恶心、呕吐的风险．需加以防范。

Objective To evaluate the efficacy of midazolam combined with remifentanil for low er eyelid blephamoplasty. Methods In a double-blind study, 200 patients undergoing lower eyelid blephamoplasty were randomly and equally divided into 2 groups （100 cases each）： test group （mid azolam 0.05 mg/kg and remifentanil 0.5 μg/kg followed by remifentanil 0.05 /lg/（kg.min） and control group （midazolam 0.05 mg/kg）. Heart rate （HR）, mean arterial pressure （MAP）, and pulse oxygen saturation （SpO2）, respiratory rate （RR）, SpO2 change, operation time. recovery time, the incidence of adverse reactions and the satisfactory rate of both patients and surgeons were monitored and recorded before tile medication. 3 rain after the medication, at beginning of the surgery, during and immediately after the surgery, and 30 rain after surgery. Results Two groups of patients had no obvi- ous difference in intraoperative MAP, HR, RR, SpO2 and postoperative recovery time （P〈0. 05）; the incidence of postoperative nausea and vomiting in the test group was significantly higher than that in control group （P〈0.05） ; Patients and surgeons satisfaction in the test group was higher than that in control group （91. 3±11. 6）vs （52. 7±10. 4） （P〈0.05）. Conclusions Midazolam combined with remifentanil for lower eyelid blephamoplasty has less inhibitory effect on circulatory and respiratory functions and the patients come round fast after surgery. But there are risks of respiratory inhibition in the induce pbase and nausea and vomiting in the recovery stage.