小剂量咪达唑仑联合芬太尼改善老年全髋关节置换术后的镇痛效果

Effect of low dose midazolam combined with fentanyl on postoperative analgesia in elderly patients undergoing total hip arthroplasty

目的 :探讨小剂量咪达唑仑联合芬太尼进行老年全髋关节置换术后镇痛的有效性和安全性。方法 :选择68例腰麻下行全款置换的ASAⅠ~Ⅲ级老年患者,随机分为两组各34例。对照组给予芬太尼单药处理,试验组给予0.1mg/kg咪达唑仑+芬太尼联合处理,比较两组术后不同时间点静息状态下和运动状态下VAS评分、睡眠紊乱情况及不良反应。结果 :试验组在术后4~48 h VAS评分、睡眠紊乱发生率及患者恶心、呕吐发生率均较对照组低(P<0.05)。结论 :小剂量咪达唑仑联合芬太尼能有效地进行术后镇痛,且能改善患者术后睡眠质量和术后恶心、呕吐的发生率。

Objective:To investigate the efficacy and safety of low dose midazolam combined with fentanyl for postoperative analgesia in elderly patients undergoing total hip arthroplasty.Methods:A total of 68 patients at ASAⅠ~Ⅲundergoing total hip arthroplasty under lumbar anesthesia were randomly divided into a control group(giving fentanyl 18 mg/kg only)and an experimental group(giving 0.1 mg/kg midazolam combined with fentanyl 18 mg/kg)with 34 cases each.VAS scores at rest and under exercise at different postoperative time points and the incidence of sleep disorder and adverse reactions after surgery were compared between the two groups.Results:VAS scores at postoperative 4 h,6 h,12 h,24 h and 48 h and the incidence of sleep disorder and nausea and vomiting were lower in the experimental group than the control group(P<0.05).Conclusion:Small dose of midazolam combined with fentanyl can effectively relieve postoperative pain,improve sleep quality and reduce the incidence of nausea and vomiting after operation.