摘要
目的:探讨非全麻骨科手术的辅助用药。方法:非全麻骨科择期手术60例,随机分为3组,分别用力月西0.03mg/kg+芬太尼1μg/kg(A组);力月西0.05mg/kg+芬太尼1μg/kg(B组);氟哌啶醇50μg/kg+芬太尼1μg/kg(C组),于麻醉显效,手术开始前5分钟静脉滴入。给药前、给药后30、60分钟及手术后4小时分别进行记忆卡实验、镇静评估、监测术中血压、脉率、呼吸次数、脉搏血氧饱和度,记录不良反应,并于手术后随访,进行麻醉满意度调查评分。结果:3组患者在给药后30分钟、60分钟及手术后4小时多数能正确复述第一张记忆卡内容(P>0.05);手术后4小时能较准确复述第二张记忆卡内容者,B组明显少于A组和C组(P<0.01);B组比A组遗忘者更多(P>0.05)。获得镇静状态2～4级者,A组和C组差异无显著性(P>0.05);B组镇静效果明显强于A组和C组(P<0.05)。给药后30分钟,3组患者血压均呈下降趋势,但未超过基础血压的30%;脉率、呼吸和脉搏氧饱和度无明显变化。手术后4小时麻醉满意度调查显示,B组明显优于A组和C组(P<0.05)。结论:非全麻骨科手术中应用力月西+芬太尼作为辅助用药,不仅能获得良好的镇静、镇痛作用,且具有顺行性遗忘效果,对手术无不良记忆,是其他药物所无法比拟的。
Objective：The purpose of this study was to investigate the clinical effects of the different dosages of midazolam plus fentanyl and haloperidol plus fentanyl as an assistant medication of local block anaesthesia in orthopedics surgery.Methods ： 60 patients undergoing non-general anaesthesia orthopedics surgery were divided into three groups randomly, using midazolam 0.03mg/kg plus fentanyl 1μg/kg （group A） or midazolam 0.05mg/kg plus fentanyl 1μg/kg （group B） or Haloperidol 50μg/kg plus fentanyl 1μg/kg （group C） as an assistant medication of block anaesthesia at 5 minutes before the surgery by vein injection separately. The clinical data including the memory card experiment, sedation condition,blood pressure（BP）,pluse rate（P）,breathing rate（R） and pulse blood oxygen degree of saturation （SpO2） in all the patients were recorded at the time before（T0） operation or 30mins（T1）,60mins（T2） after giving the assistant drugs, and 4 hours（T3） after operation separately. The perioperative adverse reaction and follow-up visiting on anaesthesia satisfaction degree after surgery were also observed and evaluated.Results：The most patients of the 3 groups could correctly repeat the first memory card content at the time of T1 ,T2 and T3 （P〉0.05）;At the time of T3 ,the number of patients who could accurately repeat the second memory card content in group B was significantly less than that in group A and group C （P〈0.01）;There was not significant different in the number of patients obtaining sedation condition at 2-4 levels between group A and group C （P〉0.05）;but the sedation effect in group B was obvious strong compared with that in group A or group C （P〈 0.05）. At the time of T1 and the BP of all patients in three groups decreased, but had not surpassed 30% of foundation blood pressure; The P, R and SpO2 did not change obviously. The result of anaesthesia satisfaction at T3 in group B was significantly better than that in group A and group C （P〈0.05）.Conclusion：In non-general anaesthesia orthopedics surgery, the use of midazolam and fentanyl as an assistant medication of local block anaesthesia can obtain good sedation and analgesia effect and comfortable anterograde amnesia.
出处
《现代医药卫生》
2008年第2期183-184,共2页
Journal of Modern Medicine & Health
关键词
力月西
芬太尼
氟哌啶醇
非全麻骨科手术
记忆卡
镇静状态
VAS评分
Midazolam
Fentanyl
Haloperidol
Non-general anesthesia orthopedics surgery
Memory card
Sedation condition
VAS score
