摘要
目的 观察咪达唑仑联合氟马西尼在全凭静脉麻醉中的应用效果.方法 选择2012年1-12月择期手术患者78例,ASAⅠ~Ⅱ级.麻醉诱导：依次静脉注射咪达唑仑、舒芬太尼、罗库溴铵;麻醉维持：咪达唑仑、瑞芬太尼和罗库溴铵持续静脉输注.手术结束时静脉推注氟马西尼、新斯的明和阿托品.观察诱导前（T0）、插管前1 min（T1）、插管即刻（T2）、手术操作开始即刻（T3）、手术结束时（T4）、拔管即刻（T5）、拔管后10 min（T6）的平均动脉压（MAP）和心率（HR）变化,记录自主呼吸恢复时间、意识恢复时间和拔管时间,评估拔管后1 min清醒评分及清醒评分达6分时间,评价其安全性.结果 本组自主呼吸恢复时间为（3.4±0.7）min,静脉注射氟马西尼后所有患者意识恢复时间为（2.6±0.7）min,拔管时间（4.4±1.2）min;拔管后1 min清醒评分为（3.0±0.1）分,清醒达6分时间为（6.1±1.2）min.MAP和HR在T1、T3和T4时段与T0比较明显下降,差异有统计学意义（P＜0.05）.2例术中MAP下降,麻醉恢复期有1例发生烦躁,术后发生恶心、呕吐2例,均无术中知晓发生.结论 咪达唑仑全凭静脉麻醉效果可靠,术毕用氟马西尼拮抗,麻醉苏醒迅速、完全,且安全性较高.
Objective To observe application effect of Midazolam combined with Flumazenil during total intravenous anesthesia. Methods A total of 78 patients undergoing selective operations with grade ASA I - II form 2012 January to December were selected. Midazolam, Sufentanil and Rocuronium were intravenously injected one by one to achieve anesthesia induction; anesthesia maintenance was achieved by continuous intravenous infused with Midazolam, Remifentanil and Rocuronium. Patients were intravenously injected with Flumazenil, Neostigmine and Atropine at the end of the surgery. Changes of mean arterial pressure （MAP） and heart rate （HR） were observed before induction （To） , 1 min before intubation （T1） , intubation （T2 ） , surgery start time （T3） , the end of surgery （T4） , extubation （T,） and 10 min after extubation （T6） ; spontaneous breathing recovery time, consciousness recovery time and extubation time were recorded; sober ratings 1 min after extubation, the time of sober ratings reached 6 points and its safety was assessed. Results Patients＇ breathing recovery time was （3. 4 ± 0. 7） min, consciousness recovery time was （2. 6 ± 0. 7） min after Flumazenil intravenous injection, and extubation time was （4. 4 ± 1. 2） min; sober ratings 1 min after extubation was （3.0 ± 0. 1） scores, and sober time reached 6 scores was （6. 1 ± 1. 2） min. Levels of MAP and HR at T, , T3 and T4 significantly decreased compared with those at To （P 〈 0. 05）. Intraoperative MAP level decreased in two patients, one patient had agitation during the anesthesia recovery period, 2 patients had postoperative nausea and vomiting, but there was no intraoperative awareness. Conclusion Midazolam used during total intravenous anesthesia is safe, and Flumazenil used at the end of surgery may help patients recover from anesthesia quickly and completely.
出处
《解放军医药杂志》
CAS
2014年第1期70-72,共3页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
衡水市科技研究与发展计划(12020A)
关键词
咪达唑仑
麻醉
静脉
氟马西尼
麻醉品拮抗药
Midazolam
Anesthesia, intravenous
Flumazenil
Narcotic antagonist
