咪达唑仑联合催眠疗法在硬膜外麻醉下老年患者术中镇静的效果观察

Sedation effect observation of Midazolam combined with hypnotherapy under epidural anesthesia in operation in elderly patients

目的探讨硬膜外麻醉下咪达唑仑联合催眠疗法在老年患者术中的镇静效果。方法选择2012年1月-2014年12月我院行硬膜外麻醉下腹股沟疝修补术的老年男性患者90例,随机将其分为3组,每组30例。组1给予催眠疗法,组2给予咪达唑仑联合催眠疗法,组3给予咪达唑仑疗法。记录每组患者SCL-90焦虑因子评分,入室、干预前、干预后、离室的收缩压（SBP）,舒张压（DBP）,心率（HR）,血氧饱和度（Sp O2）,呼吸频率（RR）,Narcotrend指数,术后苏醒时间,发生不良反应例数,术中干预例数,用药处理例数,患者的遗忘程度。结果干预后,与组1、组3比较,组2的SCL-90焦虑因子评分、SBP、DBP、HR、Sp O2、RR、Narcotrend指数、患者的遗忘程度差异有统计学意义（P〈0.05）。与组1、组2比较,组3的苏醒时间、特殊用药、不良反应和干预处理比例差异有统计学意义（P〈0.05）。结论硬膜外麻醉下咪达唑仑联合催眠疗法在老年患者术中的镇静效果好,降低了呼吸抑制和低血压风险。

Objective To explore the sedation effect of Midazolam combined with hypnotherapy under epidural anesthesia in elderly operation. Methods 90 elderly men with inguinal hernia repair under epidural anesthesia in our hospital from January 2012 to December 2014 were randomly divided into three groups（each group was 30 cases）： group 1 was given hypnotherapy for treatment; group 2 was given Midazolam combined with hypnotherapy for treatment,and group 3was given Midazolam for treatment.The SCL-90 factor scores anxiety,SBP,DBP,HR,Sp O2,RR,Narcotrend,recovering time,numbers of adverse effects,intervention numbers during operation,drug treatment cases,and amnesia degree of patients in groups at entering the room,before intervention,after intervention and leaving room were recorded. Results After intervention,the difference of SBP,DBP,HR,Sp O2,RR,Narcotrend,SCL-90 factor scores anxiety and amnesia degree of patients in group 2 had statistical significance compared with group 1 and group 3（P〈0.05）.The difference of recovering time,drug treatment cases,numbers of adverse effects and intervention numbers during operation in group 3 had statistical significance compared with group 1 and group 2（P〈0.05）. Conclusion Midazolam combined with hypnotherapy under epidural anesthesia in elderly operation with better sedation effects and decreases the risk of respiratory depression and hypotension.