摘要
目的:探讨持续输注瑞芬太尼+咪唑安定辅助硬膜外麻醉对腹部手术中牵拉和遗忘的影响。方法:30例手术病人,随机分两组。Ⅰ组:术前10min开始持续输注瑞芬太尼0.1μg/(kg·min)+咪唑安定0.50μg/(kg·min),术中维持OAA/S评分2～3分至手术结束;Ⅱ组:术前10min缓慢静注哌替啶50mg+氟哌利多2.5mg。记录HR、MAP、SpO2的变化,OAA/S评分和内脏牵拉反应。术后24h随访。结果:Ⅰ组静脉用药期间HR、MAP、SpO2变化无显著性差异(P>0.05)。与Ⅰ组相比,Ⅱ组用药后HR增加显著、MAP下降显著(P<0.05)。术中OAA/S评分处于2～3分、内脏牵拉反应优良、对手术过程全无记忆、愿意在以后类似手术选择同样麻醉方法的患者,Ⅰ组均显著多于Ⅱ组(P<0.05)。结论:持续输注瑞芬太尼+咪唑安定辅助硬膜外麻醉,控制OAA/S镇静评分2～3分,有助于减少腹部手术的牵拉和不良记忆。
Objective To investigate the effects of assisted epidur al anesthesia with continuous infusions of remifentanil and midazolam on viscera trcation and oblivion in abdomen operation. Methods 30 ASA Ⅰ-Ⅱ patients undergoing operation in abdomen with epidural anesthesia were randomly divided into two groups with 15 patients each. In group Ⅰ:remifentanil at a rate of 0.1μg·kg -1·min -1and midazo lam at a rate of 0.50μg·kg -1·min -1 were infused continuously 10 m inutes before operation. The level of sedation was evaluated by OAA/S score. OAA /S score was maintained at 2 or 3 by adjustment of the rate until operation ende d. In group Ⅱ:pethidine 50mg and droperidol 2.5mg were infused slowly 10 minut es before operation. HR,MAP, SpO2,OAA/S score and viscera tuaction were record ed. Oblivion of patient on operation and whether or not the patient would choose the same anesthesia method in similar operation later were investigated in 24 h ours after operation. Results There was no statistical change in HR,MAP and SpO2 in gro up (P>005).In group Ⅱ,compared with that in groupⅠ,HR increased at 2 and 5minutes after infusion (P>005)and MAP decreased at 30 inutes after infusion(P>005).The numbers of the patients withe OAA/S score maintain ed at 2 or 3, good response to viscera traction, oblivion on operation and the w illing that would chose the same anesthesia again in similar operation were high er in group Ⅰthan that in group Ⅱ (P>005). Conclusion Assisted epidural anesthesia with continuous infusion of remifentanil and midazolam and maintaining OAA/S score at 2 or 3 is helpful to d ecreas viscera traction and harmful memory in abdomen operation.
出处
《第一军医大学分校学报》
2005年第1期44-46,共3页
Journal of Branch Campus of the First Military Medical University
关键词
硬膜外麻醉
瑞芬太尼
咪唑安定
腹部手术
内脏牵拉
遗忘
Epidural anesthesia
remifentanil
midazolam
abdominal surgery
viscera traction
oblivion
