舒芬太尼-咪唑安定静脉全麻复合硬膜外阻滞对血流动力学及麻醉后清醒的影响

Effects of sufentanil-midazolam intravenous anesthesia combined with epidural block on hemodynamics and anesthesia awake

目的研究舒芬太尼-咪唑安定静脉全麻复合硬膜外阻滞对血流动力学及麻醉后清醒的影响。方法选取2015年1月~2016年12月择期于台州市肿瘤医院进行胸部和腹部手术的40例患者作为本研究的研究对象,随机分为对照组和试验组,每组患者各为20例。对照组患者进行舒芬太尼-咪唑安定静脉全麻,试验组患者进行舒芬太尼-咪唑安定静脉全麻复合硬膜外阻滞。比较分析试验组与对照组患者血流动力学及麻醉后清醒的情况。结果试验组与对照组患者插管前舒张压、收缩压、心率与进行诱导前相比均显著降低,差异具有统计学差异（P〈0.05）,其他观察时间点2组患者比较差异无统计学意义。试验组患者静脉麻醉用药显著少于对照组,差异具有统计学差异（P〈0.05）。试验组患者苏醒时间为（31.5±4.2）min,拔管时间为（4.8±1.5）min,基本清醒时间为（8.2±2.4）min,以上数据均显著优于对照组,差异有统计学意义（P〈0.05）。试验组与对照组患者均无术后躁动以及呼吸抑制等并发症出现。结论舒芬太尼-咪唑安定静脉全麻复合硬膜外阻滞,患者血流动力学稳定,能够在一定程度上减少麻醉用药,缩短苏醒时间,值得临床应用。

Objective To investigate the effect of sufentanil midazolam intravenous anesthesia combined with epidural block on hemodynamics and postoperative consciousness after anesthesia. Methods 40 cases undergoing acute chest and abdominal surgery from January 2015 to December 2016 in Taizhou tumor hospital as the research objects,were randomly divided into the control group and the experimental group,20 cases in each group. The control group were received sufentanil midazolam intravenous anesthesia,and the experimental group were received sufentanil midazolam intravenous anesthesia combined with epidural block. Hemodynamics and anesthesia consciousness in the two groups were compared. Results Compared with preinduction,the diastolic and systolic blood pressure and the heart rate were significantly decreased at pre-intubation（ P 〈0. 05）. There were no significant differences between the two groups at other observation time points. The intravenous anesthesia medication in the experimental group was significantly less than that in the control group,the difference was statistically significant（ P 〈0. 05）. The recovery time in the experimental group was（ 31. 5 ± 4. 2）min,the extubation time was（ 4. 8 ± 1. 5） min,and the basic awake time was（ 8. 2 ± 2. 4） min. The above data were significantly better than those in the control group（ P 〈0. 05）. No complications such as postoperative agitation and respiratory depression occurred in the experimental group and the control group. Conclusion Sufentanil midazolam intravenous anesthesia combined with epidural block,hemodynamic stability,it can reduce the amount of anesthesia drugs and shorten the recovery time to some extent,and is worthy of clinical application.