布托啡诺复合咪达唑仑与哌替啶复合异丙嗪对减轻胃穿孔修补术术中患者胃牵拉反应的作用

摘要

[目的]探讨布托啡诺复合咪达唑仑与哌替啶复合异丙嗪对减轻胃穿孔修补术术中患者胃牵拉反应的作用.[方法]100例行胃穿孔修补术患者,硬膜外麻醉满意后在切皮前5 min,50例予布托啡诺+咪达唑仑静脉注射为 A 组,另50例予哌替啶+ 异丙嗪静脉注射为 B组.比较两组心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2)变化、Ramsay镇静评分及胃牵拉反应程度.[结果]与用药前(T0)比较,A组用药后1 min(T1)、用药后5 min(T2)、用药后10 min(T3)、术毕(T4)的 HR、MAP、SpO2基本平稳(P>0.05);B组HR、MAP有明显波动(P<0.05),SpO2基本平稳(P>0.05).两组T1、T2的Ramsay镇静评分相比较差异无显著性(P>0.05),T3、T4时A组Ramsay镇静评分明显大于B组(P<0.05).A组胃牵拉反应优良率为86%(43/50)明显高于B组的70%(35/50)(P<0.05).[结论]布托啡诺复合咪达唑仑能明显减轻术中胃牵拉反应,其作用优于哌替啶+异丙嗪.%[Objective]To investigate the effect of butorphenol combined with midazolam and pethidine combined with promethazine on relieving gastric stretch in patients with gastric perforation repair.[Methods]Among 100 patients undergoing gastric perforation repair,50 patients were treated with butorphen and mid-azolam intravenously in 5 minutes before incision after satisfactory epidural anesthesia.The other 50 cases were given pethidine plus promethazine intravenously as group B.The changes of heart rate,mean arterial pressure (MAP),pulse oxygen saturation(SpO2),Ramsay sedative score and the degree of gastric retraction were compared between the two groups.[Results] Compared with T0 before treatment,HR,MAP,SpO2at T1~T4after treatmentin the group A were stable(P >0.05),and HR and MAP in the group B were fluctuating significantly(P <0.05),while SpO2was stable(P >0.05).There were no significant difference between the two groups compared Ramsay scores at T1and T2(P <0.05),while at T3and T4in the group A were signifi-cantly higher than those in the group B(P <0.05).The excellent and good rate of in the group A(86%)was significantly higher than that in the group B(70%)(P <0.05).[Conclusion]Midazolam combined with Bhut-to enphol can significantly reduce the effect of gastric traction in the operation,and its effect is better than pi-peridine + promethazine.