咪唑安定配伍不同药物对辅助硬膜外麻醉的临床效果论文.docVIP

　　咪唑安定配伍不同药物对辅助硬膜外麻醉的临床效果论文 .freelin后静脉给药，术中观察并记录给药后10min内的BP，HR和SpO2 变化，患者镇静程度，不良反应发生率.freelsay4级镇静所需时间MF:（1.5±1.0）min，MP:（1.7±1.1）min，MDP:（3.5±2.0）min、明显短于DP组:（5.8±2.8）min（P 0.05）;而MDP组维持4级以上镇静的作用时间是（115.7±16.8）min显著长于其他3组［MP:（80.0±32.1）min;DP:（68.0±49.5）min;MF:（56.4±19.1）min］（P 0.05）;伍用咪唑安定的3组患者产生遗忘作用高于DP组，且患者的满意度相对较高（P 0.05），但各组术中牵拉反应发生率无差异，MP与MDP组舌后坠发生率较高（P 0.05）. 结论 硬膜外麻醉时咪芬合剂是1～2h手术的最佳辅助用药，咪氟哌联合用药适用于镇静需求高，时间 2h的手术.咪氟合剂具有起效快，减少术中不良记忆，对循环呼吸干扰小，提高麻醉满意率的优点. Keyidazolam;anesthesia，epidural;analgesia Abstract:AIM To investigate the sedative，analgesic and preventive effects against side-effects of intravenous adminis-tration of midazolam（M）inal surgery under epidural anesthe┐sia.METHODS 80ASA II～III patients，scheduled for elective abdominal surgery ized into four groups:Group DP，droperidol5mg+pethidine100mg as1U;Group MF，midazolam4mg+fantanyl0.1mg as1U;Group MP，midazolam4mg+pethidine100mg as1U and Group MDP，DP1U+midazolam4mg.All the drugs in after the first dose of epidu-ral local anesthetic.The dose of various binations say4.The patients’requirement for sedation onitored，the de-gree of sedation and the side-effects nesia and satisfaction of anesthesia.RESULTS 68%pa-tients had the clear requirement for sedation during the oper-ation.There e reaching Ramsay4of sedation degree，Group MF in，MP（1.7±1.1）min and MDP（3.5±2.0）min in（P 0.05）.The sedative time above Ramsay4in Group MDP（115.7±16.8）min in，DP:（68.0±49.5）min and MF:（56.4±19.1）min］（P 0.05）.The groups in idazolam nesia effect and higher pa-tient satisfaction.Ho bined ost effective bination to supplement epidural anesthesia for1～2h operations.MF bination has the advantages of rapid onset time，remarkable amnesia，loproved satisfaction of anesthesia.If the procedure lasts for more than2h and deeper sedation is required，the MDP bina-tion is indicated. 0 引言 硬膜外麻醉是临床常用的麻醉方法之一，由于其阻滞范围和深度受多种因素限制，常需辅以催眠、镇痛药物达到镇静、减轻牵拉反应、恶心等不良反应的目的.常用的静脉辅助药包括:氟哌啶-哌替啶合剂（氟哌合剂）、氟哌啶-芬太尼合剂及异丙嗪-哌替啶合剂等，虽然取得一定效果，但仍有副作用且遗忘作用差.咪唑安定是一种新型苯二