诺扬复合咪达唑仑在高血压患者全麻拔管期的临床应用观察

摘要

目的 观察诺扬复合咪达唑仑对全麻高血压患者气管拔管时心血管反应及术后不良反应的预防作用.方法 选择全身麻醉的高血压患者60例,随机分为对照组(Ⅰ组)、诺扬组(Ⅱ组)及诺扬+咪达唑仑组(Ⅲ组),三组麻醉诱导及维持方式相同.拔管前分别予0.9％等体积生理盐水,0.02mg/kg诺扬,0.01 mg/kg诺扬+0.02mg/kg咪达唑仑.记录各时点SBP、DBP、HR、SpO2,比较各组拔管时间、术后不良反应.结果 Ⅱ、Ⅲ组患者围术期SBP、DBP、HR、SpO2变化平稳,明显优于Ⅰ组,恶心呕吐、躁动的发生率也少于Ⅰ组(P＜0.05).拔管时间Ⅰ、Ⅱ组无统计学差异,但均短于Ⅲ组(P＜0.05).结论 高血压患者在拔除气管导管前给予诺扬复合咪达唑仑能有效预防气管拔管时的心血管反应,且不良反应少.%Objective To observe the prevention effects of combination using of butorphanol and midazolam on anthesia extubation induced cardiovascular and postoperation adverse reaction. Methods 60 patients with primary hypertension were divided into 3 groups at random, controlled group (Ⅰ group) , butorphanol group (Ⅱ group) and butorphanol combined with midazolam group (Ⅲ group) , and used the same method of anesthesia induction and maintenance among 3 groups. Before extubation, the 0. 9% normal saline, butorphanol 0. 02mg/kg and butorphanol 0. 01mg/kg combined with midazolam 0. 02mg/kg were injected respectively for the 3 groups. The parameters of SBP、DBP、HR、SpO2, extubation time and postoperative side effects were recorded. Results The extubation SBP、DBP、HR、SpO2 of group Ⅱ and group Ⅲ were keeping more stable than group Ⅰ( P <0.05). The number of patients with nausea and vomiting, resdessness in group 1 was more than other 2 groups. Extubation time between group 1 and II were not statistically significant but all shorter than group III( P <0. 05). Conclusion using of butorphanol and midazolam in patients with hypertension can effectively prevent tracheal extubation induced cardiovascular response and with less adverse reactions.