本文選題：咪達(dá)唑侖 + 術(shù)前焦慮　； 參考：《廣西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：研究術(shù)前使用咪達(dá)唑侖對(duì)擇期腰椎手術(shù)患者抗焦慮作用,及該方法對(duì)術(shù)中丙泊酚用量和術(shù)后恢復(fù)的影響。方法：將擬行腰椎手術(shù)的40例患者,隨機(jī)分成兩組：咪達(dá)唑侖組(M組)及對(duì)照組(N組),每組各20例。術(shù)前1d對(duì)患者采用焦慮自評(píng)表(SAS)、狀態(tài)-特質(zhì)量表(STAI)、簡(jiǎn)易智能狀態(tài)量表(MMSE)、視覺(jué)疼痛評(píng)分法(VAS)對(duì)患者進(jìn)行評(píng)分,所有患者術(shù)中均采用BIS監(jiān)測(cè)麻醉深度。M組患者麻醉誘導(dǎo)前30min予緩慢(20S)靜脈注射咪達(dá)唑侖0.05 mg/kg (lmg/ml), N組患者靜注等量生理鹽水。監(jiān)測(cè)入室后5min(T0)、插管時(shí)(T1)、切皮即刻(T2)、術(shù)畢(T3)、拔管時(shí)(T4),出麻復(fù)室(T5)對(duì)應(yīng)時(shí)點(diǎn)的脈搏血氧飽和度(Sp02)、呼吸頻率(RR)、平均動(dòng)脈壓(MAP)和心率(HR)。記錄麻醉誘導(dǎo)時(shí)丙泊酚的用量,術(shù)畢麻醉藥用量,麻醉恢復(fù)室及術(shù)畢24小時(shí)鎮(zhèn)痛藥用量。術(shù)后2h、 4h、6h、12h、1d、2d、3d用疼痛視覺(jué)模擬評(píng)分法(VAS評(píng)分)評(píng)估患者術(shù)后疼痛情況,術(shù)后1d采用焦慮自評(píng)表(SAS)、狀態(tài)-特質(zhì)量表(STAI)及術(shù)后1d、2d、3d采用簡(jiǎn)易智能狀態(tài)量表(MMSE)對(duì)患者進(jìn)行評(píng)分,觀察患者術(shù)后惡心嘔吐等不良反應(yīng)的情況。結(jié)果：1.兩組患者性別、年齡、身高、體重、文化程度等一般情況比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；2.兩組患者各時(shí)間點(diǎn)MAP和HR比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；3.M組患者麻醉誘導(dǎo)時(shí)及術(shù)中麻醉藥用量比N組低(P0.05)；4.M組術(shù)后1dSAS、SAI評(píng)分較N組低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；5.M組術(shù)后2h、4h的VAS評(píng)分比N組患者低(P0.05)；結(jié)論:術(shù)前使用咪達(dá)唑企抗焦慮治療可減少擇期腰椎手術(shù)患者麻醉誘導(dǎo)期及維持階段的麻醉藥用量,并可減輕術(shù)后早期疼痛癥狀,且不增加不良反應(yīng)的發(fā)生率。
[Abstract]:Objective: to study the antianxiety effect of midazolam before operation and the effect of midazolam on intraoperative propofol dosage and postoperative recovery.Methods: forty patients undergoing lumbar surgery were randomly divided into two groups: midazolam group (n = 20) and control group (n = 20).One day before operation, the patients were assessed with SAS, STAI, MMSE and VASS.All patients were given intravenously midazolam with midazolam (0.05 mg/kg / ml) before anesthesia induction with BIS monitoring anesthesia depth. Group N was given the same amount of normal saline intravenously.The blood oxygen saturation (SP02), respiratory frequency (RRN), mean arterial pressure (MAPP) and heart rate (HRP) were monitored at 5 min after entering the room, 5 min after entering the room, 5 min after intubation, immediately after incision of T2, T3, T4, T5) at the corresponding time point.The dosage of propofol during anesthesia induction, the dosage of anesthetic after operation, the dosage of analgesics in recovery chamber and 24 hours after operation were recorded.The adverse reactions such as nausea and vomiting were observed.The result is 1: 1.There was no significant difference in sex, age, height, weight and education between the two groups.There was no significant difference in MAP and HR between the two groups at each time point. 3. The dosage of anesthetic in group M was lower than that in group N during anesthesia induction and in group N. The score of SASSAI in group M was lower than that in group N on the 1st day after operation, and the score of SASSAI in group M was lower than that in group N at one day after operation.The difference was statistically significant (P 0.05). The VAS score of group M was significantly lower than that of group N at 2 hours after operation. Conclusion: before operation, midazolidazole antianxiety therapy can reduce the dosage of anesthetic in induction and maintenance stage of anesthesia in patients undergoing selective lumbar surgery.And can alleviate the early postoperative pain symptoms, and do not increase the incidence of adverse reactions.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R614

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