咪达唑仑清醒镇静在内镜逆行胰胆管造影中的应用研究

目的探讨咪达唑仑在ERCP中的镇静作用。方法将100例拟行ERCP检查和治疗的患者随机分为试验组和对照组,每组50例。两组术前均常规口服利多卡因止痛胶,给予氢溴酸山莨菪碱10mg静脉注射。试验组同时静脉注射咪达唑仑(0.06mg/kg体重)。监测患者术前、术中、术后的BP、HR、SPO2。观察两组患者的手术操作时间、镇静程度、手术依从性和耐受性及术后次日对操作的遗忘程度和满意度。结果试验组患者围术期BP、HR平稳;镇静程度适中,依从性和耐受性良好;术后患者对操作遗忘程度及满意度较高,与对照组比较,差异均有显著性(P<0.05或P<0.01)。结论ERCP术前静脉注射咪达唑仑可提高麻醉效果,有利于患者配合手术。

Evaluation of conscious sedation with midazolam for endoscopic retrogradecholangiopancreatography.

Objective To assess the conscious sedative effect of midazolam during the procedure of endoscopic retrograde cholangiopancreatography(ERCP).Methods 100 patients undergoing ERCP were randomly divided into two groups,which were the disposal group(n = 50)and the control group(n = 50).The patients of the both groups were intravenously given 10mg 654-2 before the procedures,while the patients in the disposal group received intravenous conscious sedation agent midazolam with dosage of 0.06 mg/kg 5mins before the procedure.Heart rate(HR),blood arterial pressure(Bp)and oxygen saturation(SpO2)were monitored.The duration of procedure,level of sedation,patient cooperation and tolerance,level of amnesia and satisfaction with regard to the procedure were recorded.Results The perioperative Bp and HR in the disposal group were stable.The levels of sedation(Ramsay)were largely within 2 ~ 4 scales and with a higher patient compliance and satisfaction in the disposal group.The level of amnesia was as good as that in the control group(P < 0.01 or P < 0.05).Conclusions Concious sedation by intravenous injection with midazolam was safe and effective during the procedure of ERCP.