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局麻复合咪达唑仑舒芬太尼在眼科整形手术中的观察

郑超,顾恩华,王淑珍   

  1. 天津市眼科医院
  • 收稿日期:2013-05-17 修回日期:2013-10-23 出版日期:2014-03-15 发布日期:2014-03-15
  • 通讯作者: 郑超

Evaluation of local anesthesia with midazolam and sufentanil for patients in Ophthalmologic plastic surgery

  • Received:2013-05-17 Revised:2013-10-23 Published:2014-03-15 Online:2014-03-15

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摘要： 【摘要】 目的 观察局麻复合咪达唑仑、舒芬太尼用于眼科整形手术患者的镇静镇痛疗效。方法 将160例患者（ASAⅠ~Ⅱ）通过随机数字表法分为2组，每组80例。Ⅰ组：只采用局麻；Ⅱ组：局麻基础上复合咪达唑仑(0.05 mg·kg-1)、舒芬太尼(0.1 μg·kg-1)。分别记录入手术室后、局麻时、手术开始及开始后20 min和术毕时的脑电双频指数（BIS）、收缩压（SBP）、舒张压（DBP）、心率（HR）、呼吸频率（RR）、血氧饱和度（SpO2）和视觉模拟评分（VAS）。记录术中有无低氧血症、呼吸暂停、躁动、恶心、呕吐等并发症及手术时间。结果 两组患者年龄、性别、体质量及手术时间差异均无统计学意义（P＞0.05）。Ⅰ组各时段的BIS值差异无统计学意义（P＞0.05）。Ⅱ组BIS值在局麻、手术开始及开始后20 min较入室时显著降低（P＜0.05)。Ⅰ组SBP、DBP以及HR在局麻、手术开始及开始后20 min及术毕时较入室时升高，RR在局麻、手术开始及开始后20 min较入室时增快（P＜0.05）。Ⅱ组给药后SBP、DBP、HR及RR有所下降（P＜0.05）在局麻注射和手术期间Ⅰ组VAS的分数高于Ⅱ组（P＜0.05），Ⅰ组躁动15例，高于Ⅱ组的3例，Ⅱ组恶心3例，低氧血症3例，无呼吸暂停者。结论 局麻复合适宜剂量的咪达唑仑、舒芬太尼适用于眼科整形手术的麻醉，镇静镇痛效果确切，患者舒适度高，并发症少。

关键词: 局部麻醉, 咪达唑仑, 舒芬太尼, 镇静镇痛, 眼科整形术

Abstract: 　　　　　　【Abstract】 Objective to observe the application of local anesthesia with midazolam and sufentanil for patients in ophthalmologic plastic surgery. Methods The 160 patients (ASAⅠ~Ⅱ) were randomly divided into two group through the random number table,80 cases in each group. groupⅠ:local anesthesia; groupⅡ;local anesthesia with midazolam(0.05mg/kg) and sufentanil(0.1μg/kg) .Record the bispectral index(BIS),systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),respiratory rate(RR),oxyhemoglobin saturation（SpO2）,visual analogue scale(VAS) at into the operating room,during injection of local anesthesia, at the beginning of the procedure ,20min after the beginning of the procedure and after operation.Record the hypoxemia, apnoea, restlessness, nausea and vomiting and the time of operation. Results The age, gender, weight and operation time in two groups is not difference (P＞0.05). In groupⅠ, The BIS value is not significant difference in all the time(P＞0.05) . In group Ⅱ, compared with before anesthesia induction,The BIS value was significantly decreased during injection of local anesthesia, at the beginning of the procedure and 20min after the beginning of the procedure (P＜0.05). Compared with into the operating room the SBP,DBP and HR were significantly increased during injection of local anesthesia, at the beginning of the procedure, 20min after the beginning of the procedure and after the procedure, RR was increased during injection of local anesthesia, at the beginning of the procedure and 20min after the beginning of the procedure in groupⅠ(P＜0.05). Compared with before anesthesia induction the SBP, DBP, HR and RR was decreased in group Ⅱ(P＜0.05). During local anesthesia injection and procedure time ,the VAS in groupⅠis higher than groupⅡ(P＜0.05). Restlessness in 15 cases In groupⅠ was higher than 3 cases in groupⅡ. In groupⅡ nausea in 3 cases, anoxemia in 3 cases, no apnea . Conclusion consious sedation with midazolam and sufentanil is an effective anesthetic technique for patients in ophthalmologic plastic surgery.

Key words: Local anesthesia, Midazolam, Sufentanil, Sedation and analgesia, Ophthalmologic plastic surgery