摘要
目的探讨超声引导下双侧闭孔神经阻滞联合咪达唑仑静脉麻醉对膀胱癌手术患者血流动力学及苏醒质量的影响。方法选取拟行手术治疗的98例膀胱癌患者进行前瞻性随机对照研究,通过随机数字表法将其分为对照组和研究组,各49例。对照组给予咪达唑仑静脉全麻,观察组在对照组基础上联用超声引导下双侧闭孔神经阻滞。对比两组麻醉前(T1)、麻醉后20 min(T2)、麻醉后40 min(T3)、术后拔管时(T4)血流动力学[心率(HR)、平均动脉压(MAP)]、苏醒质量[Steward苏醒评分、意识状态OAAS评分(OAAS)]及咪达唑仑使用剂量。结果随着T1、T2、T3、T4时点推移,两组HR、MAP水平均下降,且观察组T2、T3、T4时点HR、MAP水平均高于对照组(P<0.05)。观察组Steward苏醒评分、OAAS评分显著高于对照组(P<0.05)。对照组咪达唑仑剂量为5~10 mg,平均(7.64±1.23)mg;观察组咪达唑仑剂量为5~8 mg,平均(6.65±0.55)mg。观察组咪达唑仑剂量显著少于对照组,差异有统计学意义(t=5.143,P<0.001)。结论超声引导下双侧闭孔神经阻滞联合咪达唑仑静脉麻醉可提高膀胱癌手术患者苏醒质量,且对血流动力学影响较小,麻醉效果好。
Objective To investigate the effect of ultrasound guided bilateral obturator nerve block combined with midazolam intravenous anesthesia on hemodynamics and recovery quality of patients undergoing bladder cancer surgery.Methods A prospective randomized controlled study was conducted on 98 patients with bladder cancer who were admitted to the hospital for surgical treatment.They were divided into the control group and the study group by random number table,with 49 cases in each group.The control group was given midazolam intravenous anesthesia,and the observation group was given ultrasound guided bilateral obturator nerve block on the basis of the control group.The hemodynamics[heart rate(HR),Mean arterial pressure(MAP)],recovery quality[Steward recovery score,OAAS score for state of consciousness(OAAS)]and the dosage of midazolam were compared before anesthesia(T1),20 minutes after anesthesia(T2),40 minutes after anesthesia(T3),and at the time of extubation(T4)after surgery between the two groups.Results With the passage of time points T1,T2,T3,and T4,the levels of HR and MAP in both groups decreased,and the HR and MAP levels in the observation group at time points T2,T3,and T4 were higher than those in the control group(P<0.05).The Steward awakening score and OAAS score in the observation group were significantly higher than those in the control group(P<0.05).In the control group,the dose of midazolam was 5~10 mg,with an average of(7.64±1.23)mg.The dose of midazolam in the observation group was 5~8 mg,with an average of(6.65±0.55)mg.The dose of midazolam in the observation group was significantly lower than that in the control group(t=5.143,P<0.001).Conclusion Ultrasound guided bilateral obturator nerve block combined with midazolam intravenous anesthesia can improve the quality of recovery of patients undergoing bladder cancer surgery,and has little impact on hemodynamics,with good anesthetic effect.
作者
司马靓杰
苗亚飞
麻黎斯
刘稳
司建洛
SIMA Liangjie;MIAO Yafei;MA Lisi(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471003)
出处
《实用癌症杂志》
2024年第6期965-968,976,共5页
The Practical Journal of Cancer
