咪达唑仑用于硬膜外术后镇痛的临床观察
 |
| 第1页 |
参见附件(3930KB，3页)。
【摘要】目的 是观察咪达唑仑用于硬膜外术后镇痛的效果。方法 将120例下肢及下腹部手术病人随机分为两组，每组60例。所用的镇痛配方：一组为咪达唑仑10mg.芬太尼0.45mg.布比卡因150mg，以生理盐水稀释至100ml；二组为芬太尼0.45mg.布比卡因150mg，以生理盐水稀释至100ml,分别从硬膜外持续泵入，速率为2ml/h,单次PCA量为0.5ml/次，负荷量均为布比卡因15mg加芬太尼0.05mg以生理盐水稀释至5ml。观察术后1h.4h.8h.12h.24h的血压.心率.血氧饱和度.镇痛效果.辅用镇痛药情况.PCA追加按压次数及不良反应。结果 两组的血压.心率.血氧饱和度在统计学上无显著差异(P>0.05), 两组的镇痛效果.辅用镇痛药情况及不良反应在统计学上有显著差异(P<0.01),一组优于二组，二组中有15例镇痛效果较差，需追加镇痛药，有15例有恶心呕吐。结论 咪达唑仑用于硬膜外术后镇痛，能够提高患者的痛阈，明显提高镇痛效果，而却可以减少不良反应。
【关键词】 咪达唑仑 硬膜外 术后镇痛
中图分类号：R614 文献标识码：B 文章编号：1005-0515(2011)3-216-02
【Abstract】 Objective is to observe the midazolam for postoperative epidural analgesia.Methods 120 patients with lower extremity and lower abdominal surgery were randomly divided into two groups of 60 cases.Used analgesic formula: a group of midazolam 10mg. Fentanyl 0.45mg. Bupivacaine 150mg, diluted with saline to the 100ml; two groups of fentanyl 0.45mg. Bupivacaine 150mg, tosaline diluted to 100ml, respectively, from continuous epidural infusion at a rate of 2ml / h, a single PCA volume 0.5ml / times, 15mg loading dose bupivacaine plus fentanyl 0.05mg were diluted with saline to 5ml.Postoperative 1h.4h.8h.12h.24h blood pressure. Heart rate. Oximetry. Analgesia. Auxiliary situation with analgesics. PCA and the number of additional adverse press.The results of two blood pressure. Heart rate. Oximetry was no statistically significant difference (P> 0.05), two groups of analgesic effect. Auxiliary with analgesic and adverse reactions in a statistically significant difference (P<0.01), a group better than the two groups, there were 15 cases in two groups of poor analgesic effect, an additional requirement of analgesics, 15 patients had nausea and vomiting.Conclusion, midazolam for postoperative epidural analgesia can improve the patient's pain threshold, significantly increased the analgesic effect, but it can reduce the adverse reactions.
我院于2007年1月至12月应用国产咪达唑仑(商品名为力月西)用于下肢及下腹部手术病人术后镇痛，现报告如下：
1 资料和方法
本文包括120例下肢及下腹部手术病人，年龄为18~70岁，ASA1~2级，包括子宫全切术20例，剖腹产术35例，卵巢囊肿切除术10例，宫外孕10例，下肢骨折内固定45例。术前均无呼吸.心血管.神经系统等慢性疾病病史，无长期服用镇痛镇静药史。术前药为肌注阿托品0.5mg，苯巴比妥钠0.1g。经L2~3或L3~4棘突间隙穿刺，行硬膜外或腰硬联合麻醉，硬膜外头向置管4cm，腰麻药为0.75%Bupivacain1~1.4ml加10%Glucose 1ml,硬膜外用药为2%Lidocain，麻醉效果确切。120例随机分为两组，各60例，一组为咪达唑仑10mg.芬太尼0.45mg.布比卡因150mg，以生理盐水稀释至100ml；二组为芬太尼0.45mg.布比卡因150mg，以生理盐水稀释至100ml,分别从硬膜外持续泵入，速率为2ml/h,单次PCA量为0.5ml/次，自控间隔时间为15分钟，负荷量均为布比卡因15mg加芬太尼0.05mg以生理盐水稀释至5ml，在手术即将结束时从硬膜外管推入，然后接上镇痛泵，所用泵均为扬州亚光医疗器械责任有限公司生产的亚光牌一次性输液泵 ......
您现在查看是摘要介绍页，详见PDF附件(3930KB，3页)。