摘要
目的：观察咪达唑仑诱导对老年患者腹腔镜胆囊切除全身麻醉后苏醒质量的影响。方法：择期行腹腔镜胆囊手术老年患者54例,65-75岁,ASAⅠ-Ⅱ级,随机分为试验组和对照组,每组27例。试验组予咪达唑仑0.05 mg/kg、异丙酚0.6-0.8 mg/kg、芬太尼4μg/kg、阿曲库铵0.7 mg/kg诱导。对照组予异丙酚1-1.5 mg/kg、芬太尼4μg/kg、阿曲库铵0.7 mg/kg诱导,气管插管后行机械通气,术中异丙酚、七氟醚维持麻醉。观察记录下列指标：诱导前即刻（T0）、插管后1 min（T1）、腹腔充气时（T2）、手术结束时（T3）、拔管时（T4）、拔管后1 min（T5）、5 min（T6）、10 min（T7）的SBP、DBP和HR;手术结束后患者睁眼时间;气管导管拔出时间;麻醉恢复室（PACU）停留时间;术后完全清醒时间;拔管后不良反应;拔管后10 min Ramsay评分。结果：与对照组比较,试验组睁眼时间、拔管时间明显延迟（P〈0.05）;拔管后呼吸抑制、舌根后坠和嗜睡的发生率明显增加（P〈0.05）;拔管10 min后Ramsay评分3-4级例数明显增多（P〈0.05）。两组T4、T5时SBP、DBP、HR较T0均明显升高,两组间差异有统计学意义（P〈0.05）。结论：咪达唑仑可能导致老年患者苏醒延迟,增加拔管后呼吸抑制和嗜睡等不良反应的发生率。
AIM： To evaluate the effects of induction with midazolam on postoperative anesthesia recovery quality in aged patients received laparoscopic cholecystectomy. METHODS： 54 ASAⅠ-Ⅱelderly patients aged 65-75 years undergoing elective laparoscopic cholecystectomy were randomly divided into 2 groups（n=27）;experimental group（Group M） and control group（Group P）.Midazolam 0.05 mg/kg,propofol 0.6-0.8 mg/kg,fentanyl 4 μg/kg and atracurium 0.7 mg/kg were intravenously administered during induction in Group M,wheareas in Group P,anesthesia was induced with propofol 1-1.5 mg/kg,fentanyl 4 μg/kg and atracurium 0.7 mg/kg.The patients were mechanically ventilated.Anesthesia was maintainded with propofol and sevoflurane.The SBP,DBP and HR were recorded immediately before anesthesia induction（T0）,1 min after intubaion（T1）,pneumopetitonium（T2）,at the end of surgery（T3）,immediately and 1 min,5 min,10 min after extubation（T4,5,6,7）.Times of open eyes,extubation,staying at PACU and being wide awake were recorded.Adverse events after extubation and Ramsay score 10 minutes after extubation were observed.RESULTS：Compared with Group P,the time of open eyes and extubation were significantly prolonged（P0.05） and the rates of post-extubation respiratory depression,glossoptosis and drowsiness were significantly increased in Group M（P0.05）.The number of samples of Ramsay score grade 3 or 4 at 10 min after extubation in Group M was increased（P0.05）.The SBP,DBP and HR at T4,T5 were obviously increased than those at T0 in the two groups.There was statistically difference between the two groups（P0.05）.CONCLUSION： Midazolam might result in postoperative recovery delay in elderly patients,and it could increase the rate of post-extubation respiratory depression,glossoptosis and drowsiness.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2011年第2期196-199,共4页
Chinese Journal of Clinical Pharmacology and Therapeutics
关键词
咪达唑仑
老年
麻醉
全身
苏醒质量
Midazolam
Aged
Anesthesia
General
Recovery quality
作者简介
仲俊峰，男，主治医生，学士，从事临床麻醉工作。Tel：13777312712 E—mail：zhongjunfeng800@126．com
蒋宗明，通信作者，男，主治医生，硕士，从事临床麻醉工作。Tel：13515852725 E-mail：jiangzhejiang120@163．com
