舒芬太尼联合咪达唑仑对骨折手术患者的镇痛效果

Sufentanil Combined with Midazolam on the Analgesic Effect of Surgical Patients with Fracture

目的:探讨舒芬太尼联合咪达唑仑对骨折手术患者的镇痛效果。方法:130例患者随机分为观察组65例和对照组65例,对照组采用芬太尼联合咪达唑仑椎管内麻醉,观察组给予舒芬太尼联合咪达唑仑椎管内麻醉;比较两组患者麻醉各时段RR、HR、Sp O2、MAP变化,检测各时段患者血清IL-6、TNF-α变化水平,麻醉期间镇静效果和术后镇痛效果。结果:两组患者麻醉后RR、HR、Sp O2、MAP均呈降低趋势,观察组T1、T2时段RR显著高于同时段对照组(P<0.05)。麻醉后两组患者Ramsay评分均呈上升趋势,观察组Ramsay评分显著高于同时段对照组(P<0.05)。从术后6h两组患者VAS评分逐渐呈上升趋势,观察组VAS评分显著低于同时段对照组(P<0.05)。从T0时段开始两组患者血清IL-6、TNF-α均呈升高趋势,在T2、T3、T4时段观察组血清水平显著低于同时段对照组(P<0.05)。结论:舒芬太尼联合咪达唑仑应用于骨折手术椎管内麻醉能够显著增强术后镇痛效果。

Objective： To investigate the effects of sufentanil combined with midazolam on the analgesic effect of surgical patients with fracture. Methods： 130 patients were randomly divided into observation group of 65 cases and 65 cases in the control group, the control group was treated with fentanyl combined with midazolam during spinal anesthesia, the observation group was given sufentanil combined with midazolam intraspinal anesthesia; anesthesia were compared between the two groups in each period of RR, HR, Sp O2, MAP change detection in each period the serum levels of IL-6, TNF- alpha level, the analgesic effect during the sedation effect and postoperative. Results：The two groups of patients after anesthesia HR, Sp O2, MAP, RR were decreased, the observation group T1, T2 period of RR was significantly higher than the same period of the control group（P〈0.05）. The Ramsay scores of two groups of patients were increased after anesthesia, the observation group Ramsay score was significantly higher than that of the control group（P〈0.05）. VAS scores of two groups were gradually increased from the postoperative 6h, the observation group VAS score was significantly lower than that of the control group（P〈0.05）. The serum levels of IL-6 and TNF- were increased in the two groups from the T0 period, and the serum level of the observation group was significantly lower than that of the control group（P〈0.05） in the T2, T3 and T4 periods. Conclusion： Sufentanil combined with midazolam in surgery of spinal anesthesia can significantly enhance the analgesic effect of postoperative fracture.