摘要
目的:探讨舒芬太尼或芬太尼复合咪唑安定用于玻璃体手术患者术中镇静、镇痛的有效性、安全性和可行性。方法:选择择期行玻璃体手术患者120例,随机分为芬太尼组、舒芬太尼组,每组各60例。在术者开始球后神经阻滞时,缓慢注射咪唑安定0.03mg/kg,芬太尼1.0μg/kg或舒芬太尼0.15μg/kg,随之手术开始。分别于手术开始前、手术开始后15,30min和手术结束时进行镇静评分和疼痛评分。手术结束时由术者评定患者合作度,由患者评定麻醉满意度,并观察术中不良反应(眼心反射、低氧血症、躁动呻吟及恶心呕吐等)的发生情况。结果:两组患者手术开始前镇静评分、疼痛评分相比,无统计学差异(P>0.05),手术开始后15,30min,手术结束时镇静评分、疼痛评分显著高于手术开始前(P<0.05)。舒芬太尼组手术开始后15,30min镇静评分显著高于芬太尼组(P<0.05)。两组手术开始后15,30min,手术结束时疼痛评分相比,无统计学差异(P>0.05)。舒芬太尼组患者麻醉满意度、患者合作度显著高于芬太尼组(P<0.05)。舒芬太尼组患者低氧血症的发生率显著低于芬太尼组(P<0.05),其它不良反应在两组间无统计学差异(P>0.05)。结论:舒芬太尼复合咪唑安定用于玻璃体手术,镇静效果好,镇痛完善,不良反应少,患者满意度高,易于配合。
AIM ： To investigate the sedation and analgesia efficacy, safety and feasibility of fentanyl sufentanil or fentanyl combined with midazolam in vitreous operation. METHODS： One hundred and twenty patients who underwent selective operation were randomly divided into sufentanil group and fentanyl combined with midazolam group each with 60 cases. From the beginning of retrobulbar nerve block, the patients were slowly injected midazolam 0.03mg/kg, fentanyl sufentanil 1. 0μg/kg or 0. 15μg/kg,and then were performed the ensuing surgery. The sedation score and pain score were evaluated before the operation, 15 minutes and 30 minutes after the operation, and at the end of the operation. At the end of surgery, the degree of patient cooperation, satisfaction with anesthesia, and intraoperative observation of adverse reactions （oculocardiac reflex, hypoxemia, restlessness and nausea and vomiting groaning, etc. ）were assessed by the patients. RESULTS： There was no significant difference in sedation score of the two groups before and after the operation （P〉0.05） ,so was pain score. 15, 30 minutes after the surgery and at the end of surgery, sedation score, pain score was significantly higher than that before surgery （P 〈 0. 05）. Sufentanil sedation score 15, 30 minutes after the surgery was significantly higher than that of fentanyl group （ P〈 0.05 ）. There was no significant difference in surgical pain score of the two groups 15, 30 minutes after the surgery （ P 〉 0.05）. Sufentanil anesthesia satisfaction of patients and the degree of patient cooperation was significantly higher than that of fentanyl group （P 〈 0. 05 ）. The incidence of hypoxemia in sufentanil group was significantly lower than that of fentanyl group （P 〈 0.05）, and there were no significant differences in other adverse reactions between the two groups （P〉0.05）. CONCLUSION： The vitreous surgery was composite sufentanil midazolam for effect in sedative , consummate in analgesia, less adverse reactions
出处
《国际眼科杂志》
CAS
2009年第7期1360-1361,共2页
International Eye Science
