地佐辛复合咪达唑仑在妇科手术硬膜外麻醉中的应用

Use of dezocine and midazolam on epidural anesthesia in gynecological operation

目的 观察地佐辛复合咪达唑仑在妇科手术硬膜外麻醉中的应用效果.方法 选择2011年3-12月于解放军第四○四医院择期行妇科手术的40例患者.将患者完全随机分为观察组和对照组,各20例.观察组静脉注射咪达唑仑3 mg,间隔5 min再静脉注射地佐辛5 mg;对照组静脉注射氟哌利多2.5 mg和芬太尼50 μg.观察2组患者入室时（T0）、切皮时（T1）、切皮后5 min（T2）、10 min（T3）、30 min（T4）各时点的血压、心率、脉搏血氧饱和度（SpO2）、Ram say镇静评分及术中的不良反应.结果 2组患者各时点血压、心率和SpO2比较,差异无统计学意义（P＞0.05）.观察组T1、T1、T3、T4各时点Ramsay镇静评分分别为（2.2±0.6）、（2.1±0.8）、（2.1±0.6）、（2.0±0.7）分;对照组分别为（3.3±0.7）、（3.2±0.9）、（3.2±0.9）、（3.3±0.6）分.2组患者间各时点Ramsay镇静评分比较,差异均有统计学意义（均P＜0.05）.观察组遗忘程度评分0分0例,1分4例（20.0％）,2分16例（80.0％）;对照组遗忘程度评分0分1例（5.0％）,1分8例（40.0％）,2分11例（55.0％）.2组遗忘程度评分比较差异有统计学意义（P＜0.05）.结论 地佐辛复合咪达唑仑用于硬膜外麻醉,能增强麻醉效果,不良反应少,减少患者对手术的不良记忆.

Objective To observe the effect of dezocine and midazolam on epidural anesthesia in gynecological operation.Methods From March to December in 2011 forty American society of anesthesiology（ASA） I or Ⅱ patients scheduled for gynecological operation,were randomly divided into two groups：the observation group and the control group.The patients in the observation group received midazolam 3 mg and dezocine 5 mg at an interval of 5 minuites,while those in the control group received droperidol 2.5 mg and fentanyl 50 μg.blood pressure（BP）,heart rate（HR）,oxygen saturation（SpO2）,the sedation effects and adverse effect were observed intraoperation.Results There were no significant differences on BP,HR and SpO2 at every time point between two groups（P ＞0.05）.The Ramsay scale at erery time point was T1 （2.2 ± 0.6）scores,T2 （2.1 ± 0.8）scores,T3 （2.1 ± 0.6） scores and T4 （2.0 ± 0.7） scores in observation group and T1 （3.3 ± 0.7）,T2 （3.2 ± 0.9）,T3 （3.2 ± 0.9） and T4 （3.3 ± 0.6） scores in control group respectively.There were significant differences on Ramsay scale at every time point between two groups（all P ＜ 0.05）.The scale of amnesia degree in observation group was 0（0.0％）,1 score（20.0％）,2 scores （80.0％） and that in control group was 0（5.0％）,1 score （40.0％）,2 scores（55.0％）.There was significant difference between two groups（P ＜ 0.05）.Conclusion Dezocine and midazolam assisted epidural anesthesia can enforce the effect of anesthesia and reduce adverse reactions and negative memories during operation.