小剂量咪达唑仑用于剖宫产术中的临床观察

目的：观察小剂量咪达唑仑复合芬太尼用于剖宫产手术时产妇抗焦虑、抗应激、抑制内脏牵拉反应的效果。方法：选择我院美国麻醉师协会I级的22-35岁产妇100例，按用药情况均分为A、B组。A组切皮前给予咪达唑仑0．03mg·kg^-1静脉注射；B组切皮前给予咪达唑仑0．03mg·kg^-1静脉注射，2min后芬太尼0．75gg·kg^-1静脉注射。观察2组产妇血压（BP）、心率（HR）等临床指标。结果：与麻醉前比较，2组产妇用药后抗焦虑作用效果显著（P〈0．05）；A组用药后BP、HR、血氧饱和度（SpO2）、呼吸频率（RR）无显著变化（P〉0．05）；B组用药后BP、HR、SpO2、RR均有所下降，与A组同一时间点比较差异有统计学意义（P〈0．05）。2组术中的牵拉反应、镇静状态、术后24h遗忘率均相似（P〉0．05）。2组产妇均未见明显不良反应发生。结论：小剂量咪达唑仑复合芬太尼在剖宫产术中有满意的镇静、抗焦虑、术后遗忘及抗内脏牵拉反应效果，但单用小剂量咪达唑仑对产妇呼吸、循环影响较小。

Clinical Observation of Small-dose of Midazolam for Cesarean Section

OBJECTIVE： To observe the clinical efficacy of small doses of midazolam and small doses of midazolam combined with fentanyl for anxiety, stress and visceral traction reaction of delivery woman undergoing cesarean section. METHODS： 100 ASA I delivery women aged 22-35 years old were divided into group A and B according to the situation of drug use. Group A and B received given intravenous bolus injection of 0.03mg·kg^-1 midazolam before skin incision, and group B was additionally given intravenous bolus injection of 0.75 mg·kg^-1 fentanyl after 2 minutes. RESULTS： After treatment, there were significant anxiolyric effects in both 2 groups. Specifically, there was no significant change in group A about BP, HR, SpO2 and RR, while those were decreased in group B, compared with group A at the same time point （P〈0.05）. There were similar in traction reaction, seda- tion, forgetting rate 24 h after surgery in 2 groups（P〉0.05）. There was no significant ADR found. CONCLUSION： Small doses of midazolam and small doses of midazolam combined with fentanyl for cesarean section can both get satisfactory results in sedafive, anxiolytic, postoperative forgotten and anti-visceral response. However, only small dose midazolam will have less effect on breathing and circulation and can get better results in cesarean section.