CAJ | 학술논문

目的：：观察静脉注射布托啡诺咪达唑仑应用于子宫切除术中抑制牵拉反应、寒战的效果及不良反应。方法：选择ASAⅠ~Ⅱ级择期硬膜外麻醉子宫切除术的患者60例,为抑制牵拉反应,根据从静脉使用的辅助药物不同随机将病例分为布托啡诺咪达唑仑组(B组)和芬太尼咪达唑仑组(F组)。所有病例均采用分次给药方式,术中出现牵拉反应时追加首次给药的1/2剂量。观察记录HR、SBP、DBP、SpO2、牵拉反应、寒战反应、镇静评分、术中循环稳定性以及不良反应。结果：2者均能有效抑制牵拉反应,相对B组而言,F组患者术中需反复追加药物(P<0．05)。 B组患者寒战程度明显轻于F组(P<0．05)。2组30 min内镇静评分无明显差异,术毕镇静评分B组高于F组(P<0．05)。 B组术中循环稳定性高于F组,不良反应无明显区别。结论：静脉注射布托啡诺咪达唑仑在子宫切除术中抑制牵拉反应效果确切,术中患者循环稳定,追加用药次数少,不良反应少,并能有效预防寒战发生,总体而言优于芬太尼咪达唑仑。
목적：：관찰정맥주사포탁배낙미체서륜응용우자궁절제술중억제견랍반응、한전적효과급불량반응。방법：선택ASAⅠ~Ⅱ급택기경막외마취자궁절제술적환자60례,위억제견랍반응,근거종정맥사용적보조약물불동수궤장병례분위포탁배낙미체서륜조(B조)화분태니미체서륜조(F조)。소유병례균채용분차급약방식,술중출현견랍반응시추가수차급약적1/2제량。관찰기록HR、SBP、DBP、SpO2、견랍반응、한전반응、진정평분、술중순배은정성이급불량반응。결과：2자균능유효억제견랍반응,상대B조이언,F조환자술중수반복추가약물(P<0．05)。 B조환자한전정도명현경우F조(P<0．05)。2조30 min내진정평분무명현차이,술필진정평분B조고우F조(P<0．05)。 B조술중순배은정성고우F조,불량반응무명현구별。결론：정맥주사포탁배낙미체서륜재자궁절제술중억제견랍반응효과학절,술중환자순배은정,추가용약차수소,불량반응소,병능유효예방한전발생,총체이언우우분태니미체서륜。
Objective:To observe the effects of intravenous butorphanol midazolam in controlling traction reaction,chills and adverse reactions in hysterectomy. Methods:60 patients with ASA Ⅰ ~Ⅱ hysterectomy in epidural anesthesia were randomly divided into B,F groups:butorphanol midazolam group and fentanyl midazolam group respectively. Drug delivery on time,and as was intraoperative traction reaction,spended half of the first dose administered. Recorded HR,SBP,DBP,SpO2 ,traction reaction, chills reactions, sedation score, intraoperative cycle stability and adverse reactions. Results:Two groups effectively inhibited traction response,demanded additional drugs repeatedly in F group in intraoperation,compared with that in B group(P<0. 05). Chills degree in B group significantly lower than in F group(P <0. 05);sedation score in two groups within 30min had no significant difference,intraoperative Bi Zhenjing score in B group was higher than in F group (P <0. 05);the cycling stability in B groupwas higher than in F group; but adverse reactions was no significant differencein two groups. Conclusion:Intravenous butorphanol midazolam in hysterectomy is exact effect of inhibiting traction reaction and intraoperative cycling unstability;have less additional drugs repeatedly and adverse reactions;and can effectively prevent chills;and is better than fentanyl midazolam.