术前抗焦虑对腰椎手术患者术中丙泊酚用量和术后恢复的影响

发布时间：2018-04-13 05:08

本文选题：咪达唑仑 + 术前焦虑　；参考：《广西医科大学》2015年硕士论文

【摘要】：目的：研究术前使用咪达唑仑对择期腰椎手术患者抗焦虑作用,及该方法对术中丙泊酚用量和术后恢复的影响。方法：将拟行腰椎手术的40例患者,随机分成两组：咪达唑仑组(M组)及对照组(N组),每组各20例。术前1d对患者采用焦虑自评表(SAS)、状态-特质量表(STAI)、简易智能状态量表(MMSE)、视觉疼痛评分法(VAS)对患者进行评分,所有患者术中均采用BIS监测麻醉深度。M组患者麻醉诱导前30min予缓慢(20S)静脉注射咪达唑仑0.05 mg/kg (lmg/ml), N组患者静注等量生理盐水。监测入室后5min(T0)、插管时(T1)、切皮即刻(T2)、术毕(T3)、拔管时(T4),出麻复室(T5)对应时点的脉搏血氧饱和度(Sp02)、呼吸频率(RR)、平均动脉压(MAP)和心率(HR)。记录麻醉诱导时丙泊酚的用量,术毕麻醉药用量,麻醉恢复室及术毕24小时镇痛药用量。术后2h、 4h、6h、12h、1d、2d、3d用疼痛视觉模拟评分法(VAS评分)评估患者术后疼痛情况,术后1d采用焦虑自评表(SAS)、状态-特质量表(STAI)及术后1d、2d、3d采用简易智能状态量表(MMSE)对患者进行评分,观察患者术后恶心呕吐等不良反应的情况。结果：1.两组患者性别、年龄、身高、体重、文化程度等一般情况比较差异无统计学意义(P0.05)；2.两组患者各时间点MAP和HR比较差异无统计学意义(P0.05)；3.M组患者麻醉诱导时及术中麻醉药用量比N组低(P0.05)；4.M组术后1dSAS、SAI评分较N组低,差异有统计学意义(P0.05)；5.M组术后2h、4h的VAS评分比N组患者低(P0.05)；结论:术前使用咪达唑企抗焦虑治疗可减少择期腰椎手术患者麻醉诱导期及维持阶段的麻醉药用量,并可减轻术后早期疼痛症状,且不增加不良反应的发生率。
[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.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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