麻醉__(期刊论文)

麻醉前应用咪唑安定对患者镇静和记忆遗忘的临床观察

http://www.100md.com 《中华现代临床医学杂志》 2000年第4期

麻醉,,硬膜外麻醉；麻醉前用药；咪唑安定；苯巴比妥钠；镇静；遗忘,1资料与方法,结果,3讨论,【参考文献】

     【摘要】目的探讨咪唑安定肌注作为椎管内麻醉前用药的镇静作用和对术中记忆遗忘的程度。方法选择ASAⅠ～Ⅱ级择期在腰硬联合阻滞下行妇科手术的患者200例，随机分为两组，每组100例，A组为咪唑安定组，对照组B组为苯巴比妥钠组。A组入室后麻醉前5min肌注咪唑安定0.1mg/kg；B组入室前肌注苯巴比妥钠0.1g。采用Ramsay镇静评分，记录BP、HR、RR、SpO2等的变化，术后24h随访患者，评价患者对麻醉操作及手术操作的遗忘程度。结果两组患者用药前后BP、HR、RR、SpO2无显著性变化(P<0.05)，均在正常范围之内。A组对麻醉和手术操作的完全遗忘率为88%，不全遗忘率为12%，而B组的完全遗忘率为0，不全遗忘率为24%，无遗忘率为76%。两组比较差异有显著性(P<0.05)。结论麻醉前5min肌注咪唑安定0.1mg/kg，可使患者消除焦虑、恐惧心理，既安静又能配合麻醉和手术体位，对麻醉和手术操作有很好的镇静和记忆遗忘作用。

    【关键词】硬膜外麻醉；麻醉前用药；咪唑安定；苯巴比妥钠；镇静；遗忘

    Clinical obervation of midazolam’s effects on the patients’ sedative and transient amnesia before being anaesthetized

    WANG Yuling,QIU Yuqun,YANG Chunxiao.Maternity & Child Care Hospital,Maoming 525000,China

    【Abstract】 Objective To explore the the effects of midazolam intramuscular injection as a medicine used before combined spinalepidural anaesthesia on calming down the patients and their forgetting degree of procedure.Methods 200 patients scheduled for gynaecological surgery under epidural or CSEA (classified as ASA Ⅰ-Ⅱ) were included in the study.Patients were randomly assigned into two groups with 100 cases each.Group A used midazolam while Group B used Phenobarbital sodium.After entering the operating room,Group A used midazolam (0.1mg/kg) as intramuscular injection 5 minutes before anaesthesia.On the other hand,Group B used phenobarbital sodium(0.1g) as intramuscular injection before entering the operating room.Then,Ramsay the changes of BP,HR,RR,SpO2,and 24 hours after the operation,the patients’ forgetting degree of procedure were observed.Results Referring to all patients,there were not any significant differences in BP,HR,RR,SpO2(P>0.05).All these were within normal ranges.In Group A the transcient global amnesia rate of was 88% while the transient partial amnesia rate was 12%.In contrast,in Group B,the transcient global amnesia rate was 0,the transcient partial amnesia rate was 24% while unforgotting rate was 76%.There was a significant difference between two groups (P<0.05).Conclusion Midazolam (0.1mg/kg) as intramuscular injection 5 minutes before anaesthesia can reduce the patients’ worries and horrors.It not only helps to keep patients sedative but also cooperate with anaesthesia and controlling body position.It has good calm and amnesia effects on anaesthesia and procedure. ......

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