咪唑安定与芬太尼复合罗哌卡因用于颈丛阻滞麻醉后对患者应激反应的影响

目的 探究与分析咪唑安定与芬太尼复合罗哌卡因用于颈丛阻滞麻醉后对患者应激反应的影响.方法选取本院2012年8月至2015年8月收治的90例接受颈丛阻滞麻醉的颈部手术患者,采取随机数字表法分为咪唑安定组、芬太尼组及对照组,各30例.咪唑安定组给予罗哌卡因复合咪唑安定,芬太尼组给予芬太尼复合罗哌卡因,对照组仅给予罗哌卡因,对比三组麻醉阻滞前、麻醉阻滞后5、20、40 rain收缩压(SBP)、舒张压(DBP)、心率(HR)及血氧饱和度(sP02).结果 对照组阻滞后5 rain SBP及DBP与阻滞前相比明显升高,差异具有统计学意义(t=3.42,5.56,P＜0.05).咪唑安定组及芬太尼组阻滞后20 rain、阻滞后40 min SBP及DBP与阻滞前相比均明显升高,但不如对照组升高显著,且芬太尼组与咪唑安定组相比SBP及DBP升高更加显著,差异具有统计学意义(t=4.23～6.19,P＜0.05).咪唑安定组及芬太尼组阻滞后20 min、阻滞后40 min HR与阻滞前相比升高,但不如对照组升高显著,差异具有统计学意义(t=5.10～6.23,P＜0.05).结论 采用咪唑安定或芬太尼复合罗哌卡因应用于颈丛阻滞麻醉后均可在一定程度上预防颈丛阻滞后血压升高、心率增快等应激反应,但咪唑安定复合罗哌卡因的效果更好,安全性较高.

Influences of midazolam or fentanyl combined with ropivacaine for cervical plexus block anesthesia on patients' stress reactions

Objective To explore the influences of midazolam or fentanyl combined with ropivacaine for cervical plexus block anesthesia on patients' stress reactions.Methods 90 patients undergoing cervical plexus block anesthesia for neck surgery at our hospital from August,2012 to August,2015 were selected and divided into a midazolam group,a fentanyl group,and a control group using random digital number table,30 cases for each group.The midazolar group were given midazolam and ropivacaine,the fentanyl group fentanyl and ropivacaine,and the control group ropivacaine.Before and 5,20,and 40 minutes after the block anesthesia,the systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),and blood oxygen saturation (SPO2) were compared between these three groups.Results The SBP and DBP were obviously higher 5 minutes after than before the block anesthesia,with statistical differences (t-3.42,5.56,P＜0.05).20 and 40 minutes after the block anesthesia,the SBP and DBP were obviously higher than those before in the midazolam group and than those in the fentanyl group,but not as obviously as those in the control group,with statistical differences (t =4.23 ～ 6.19,P＜0.05).20 and 40 minutes after the block anesthesia,the HR were obviously higher than those before in the midazolam group and the fentanyl group,but not as obviously as those in the control group,with statistical differences (t =5.10 ～ 6.23,P＜ 0.05).Conclusions Midazolam or fentanyl combined with ropivacaine for cervical plexus block anesthesia both can prevent the increase of blood pressure and heart rate,etc.after block anesthesia in some degree,but midazolam combined with ropivacaine has better effect and is safer.