摘要
目的:本文旨在观察咪唑安定联合腰硬联合麻醉对妇科手术患者术后镇痛遗忘效果。方法:将200例ASAⅠ～Ⅱ级腰硬联合麻醉下行妇科手术患者随机分为两组:咪唑安定组(A组)和对照组(B组)。两组患者分别于麻醉前30分钟静脉注射咪唑安定0.1 mg/kg和0.9%生理盐水2 mL。观察用药前后病人镇静情况,镇静分级,对麻醉和手术操作的遗忘程度和病人的心理状态。结果:根据Ramsay分级标准对患者镇静程度进行评判,两组患者都能维持5分以下镇静。A组患者镇静程度于切皮后5分钟、手术进行30分钟和手术结束时镇静程度显著优于B组患者,有统计学意义(P<0.05)。两组患者术后24小时内随访结果发现:A组患者不产生遗忘、不完全遗忘和完全遗忘人数分别占总人数的0、3%和97%;B组分别为7%、25%和68%。A组与B组比较差异有显著性(P<0.05),A组顺行性遗忘作用优于B组。结论:给予患者术前30分钟静脉注射咪唑安定0.1 mg/kg有助于提高患者术中镇静程度和术后遗忘率。故咪唑安定作为妇科手术麻醉前用药效果明确可靠。
Objective： To explore the sedative effects and anterograde amnesia effect of midazolam intravenous injection used before combined spinal-epidural anesthesia on calming down the patients and their forgetting degree of procedure.Method： 200 ASA Ⅰ-Ⅱ patients scheduled for gynecologic surgery under spinal-epidural anesthesia were included in the study.Patients were randomly assigned into two groups with 100 cases each.Group A used midazolam while Group B used 0.9% sodium as control.Group A used midazolam（0.1mg/kg） as intravenous injection 30 minutes before anesthesia while group B used 2ml 0.9% sodium as control.Record and compare the patients＇ sedative effect before operation began and the forgetting degree 24 hours after operation finished.Result： According to the Ramsay standard,the patients in group A have significant better sedative effect than group B since operation started（P0.05）.In group A the transient global amnesia rate of was 97% while the transient partial amnesia rate was 3%.Meanwhile,the transient global amnesia rate,the transient partial amnesia rate and the unforgotten rate were 68,25% and 7% in Group B separately.There was a significant difference between two groups（P0.05）.Conclusions： Midazolam（0.1mg/kg） as intravenous injection 30 minutes before anesthesia can reduce the patients＇ worries and horrors.It not only helps to keep patients sedative but also cooperate with anesthesia and controlling body position.It has good calm and amnesia effects on anesthesia and procedure.
出处
《现代生物医学进展》
CAS
2013年第21期4155-4158,共4页
Progress in Modern Biomedicine
关键词
妇科手术
腰硬联合麻醉
咪唑安定
镇静效果
顺行性遗忘
Gynecologic surgery
Epidural Anesthesia
Midazolam
Sedative effect
Anterograde amnesia
