全麻术中应用咪达唑仑镇静的安全性及有效性临床分析

Analysis on the Safety and Efficacy of Midazolam Sedation in General Anesthesia Operation

目的探讨咪达唑仑在全身麻醉手术中的镇静效果及安全性。方法选取2011年11月至2013年11月在中国医学科学院北京协和医院肿瘤医院进行全身麻醉手术的92例患者为研究对象。采用数字表随机法将患者分为丙泊酚组和咪达唑仑组,每组46例。咪达唑仑组给予咪达唑仑镇静,丙泊酚组给予丙泊酚镇静,比较两组患者镇静的安全性及有效性。结果咪达唑仑组患者Ramsay评分与丙泊酚组患者在不同时间点、组间及组间·不同时间点比较差异均有统计学意义(P<0.05);两组患者的心率在组间及组间·不同时间点的比较差异有统计学意义(P<0.05),不同时间点比较差异无统计学意义(P>0.05);平均动脉压和血氧饱和度在组间比较差异有统计学意义(P<0.05),不同时间点及组间·不同时间点比较差异无统计学意义(P>0.05);咪达唑仑组与丙泊酚组肌肉松弛药物用量比较,差异无统计学意义(P>0.05),但拔管时间、清醒时间及回答时间显著早于丙泊酚组患者(P<0.05),其恶心、寒战、嗜睡及狂躁的发生率也显著低于丙泊酚组(P<0.05)。结论咪达唑仑在全身麻醉手术中的镇静较好,不良反应少,拔管时间短、清醒时间快。

Objective To investigate the safety and efficacy of midazolam sedation in general anesthesia operation.Methods A total of 92 patients who accepted general anesthesia in Cancer Hospital of Chinese Academy of Medical Sciences from Nov.2011 to Nov.2013 were selected as research objects.All the patients were divided into midazolam group and propofol group according to random number table,with 46 cases in each group.Patients in midazolam group were given midazolam,while patients in propofol group received propofol.The safety and efficacy of sedation of the two groups were compared.Results Ramsay scores at different time points,groups and groups·different time points had statistically significant differences between the two groups（P〈0.05）.The heart rates of the two groups at different groups and groups·different time points had statistically significant differences（P〈0.05）,but there were no statistically significant difference between those at different time points（P〉0.05）.The mean arterial pressure and oxygen saturation had statistically significant differences at different groups（P〈0.05）,while had no statistically significant differences at different time points and groups · different time points（P〈0.05）.The drug dosage of muscle relaxant between the two groups had non statistically significant difference（P〉0.05）,but the extubation time,recovery time and answer time of midazolam group was earlier than propofol group（P〈0.05）,and the incidences of nausea,chills,lethargy and manic of midazolam group were lower than propofol group（P〈0.05）.Conclusion The effect of midazolam sedation is well,with less adverse reactions,shorter extubation time and faster recovery time.