咪达唑仑联合舒芬太尼无痛清醒镇静在CT引导下经皮肺穿刺术中的应用

Application of midazolam combined with sufentanil in CT-guided percutaneous lung centesis for painless sober sedation

目的观察咪达唑仑联合舒芬太尼无痛清醒镇静在CT引导下经皮肺穿刺术检查肺部病灶中的应用效果。方法将经皮肺穿刺术检查的200例患者随机分为两组,每组100例。对照组常规使用2%利多卡因5 mL局部麻醉进行手术,观察组在常规麻醉的基础上静脉推注咪达唑仑0.03 mg/kg和舒芬太尼0.08μg/kg进行手术,观察和比较两组的麻醉用药效果。结果观察组的收缩压(SBP)、舒张压(DBP)、心率(HR)和呼吸速率(RR)波动值均明显低于对照组(P<0.05或0.01);在手术过程中出现体动、咳嗽、呼吸不配合及并发症发生率也明显低于对照组(P<0.05或0.01);术后的满意度、术后遗忘程度、愿意接受再次检查率均高于对照组(P<0.01)。结论采用咪达唑仑联合舒芬太尼无痛清醒镇静在CT引导下经皮肺穿刺术检查肺部病灶中具有良好的应用效果,患者感到舒适和容易接受。

Objective To observe the effect of the application of midazolam combined with sufentanil in CT-guided percutaneous lung centesis for painless sober sedation.Methods A total of 200 cases subject to percutaneous lung centesis were randomly divided into 2 groups,100 cases in each group.The Control Group was routinely administered with the 5 ml of 2%lidocaine for local anesthesia in the operation while the Observation Group was intravenously injected the midazolam 0.03 mg/kg and the sulfentanyl 0.08μg/kg on the basis of routine anesthesia in the operation.The effect of anesthetic agents was observed and compared between two groups.Results The fluctuating values of systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and respiratory rate(RR)of the Observation Group were all significantly lower than the Control Group(P<0.05 or 0.01).The incidence of body movement,cough,uncooperative respiration and complications in the operation process of the Observation Group was all significantly lower than the Control Group(P<0.05 or 0.01).The satisfaction degree,degree of postoperative amnesia and willing to accept re-examination of the Observation Group was all significantly higher than the Control Group(P<0.01).Conclusion The midazolam combined with sufentanil in CT-guided percutaneous lung centesis for painless sober sedation has good effect.The patients feel easy to accept.