探讨小剂量咪唑安定辅助腰硬联合麻醉在妇科腹腔镜手术中的可行性

Feasibility investigatation of low-dose midazolam assisted combined spinal and epidural anesthesia in gynecological laparoscopy surgery

目的分析应用腰硬联合与小剂量的咪唑安定麻醉对行妇科腹腔镜术患者的血压和心率的影响及镇静效果。方法随机选取在医院择期行妇科腹腔镜术的100例患者为研究对象,随机将其分成对照组(n=50)与观察组(n=50)。对照组患者给予异丙酚与芬太尼全麻,而观察组患者给予小剂量的咪唑安定和丙泊酚腰硬联合麻醉。比较两组的临床效果。结果观察组在不同时段的舒张压、收缩压、心率比较,差异不显著(P>0.05);对照组在给药后5 min和15 min的舒张压明显低于给药前(P<0.05),给药后30 min的舒张压明显高于给药后15 min(P<0.05);对照组给药后的收缩压与心率均明显低于给药前(P<0.05);两组患者给药后的镇静评分均明显高于给药前(P<0.05)。观察组的拔管时间和不良反应总发生率明显优于对照组(P<0.05)。结论应用腰硬联合与小剂量的咪唑安定麻醉对行妇科腹腔镜术患者的镇静效果优异,拔管时间短,安全性较高。

Objective To analyze the effect of small dose midazolam assisted combined spinal and epidural anesthesia on blood pressure and heart rate in patients underwent gynecological laparoscopy surgery and the effect of sedation. Methods A total of 100 patients underwent gynecological laparoscopic surgery in the hospital were randomly selected as the the study objects, and randomly divided into control group（n=50） and observation group（n=50）. The control group received propofol and fentanyl anesthesia, while the observation group received low-dose midazolam and propofol combined with epidural anesthesia. The clinical efficacy of two groups was compared. Results There were no significant differences in diastolic blood pressure, systolic blood pressure and heart rate of the observation group at different time points（P〈0.05）. The diastolic blood pressure of the control group at 5 min and 15 min after administration were significantly lower than thoes before the administration（P〈0.05）. The diastolic blood pressure at 30 min after administration was significantly higher than that at 15 min after administration（P〈0.05）. The systolic blood pressure and heart rate of the control group after administration were significantly lower than those before administration（P〈0.05）. The sedation scores of the two groups after administration were significantly higher than those before administration（P〈0.05）. The extubation time and the total incidence of adverse reactions in the observation group were significantly better than those in the control group（P〈0.05）. Conclusion The lowdose midazolam assisted combined spinal and epidural anesthesia has good sedative effect in patients underwent gynecological laparoscopy surgery, the extubation time is shorter, and it has high safety.