阿片类药物滥用者中 0.5%布比卡因椎管内麻醉时辅助咪达唑仑与芬太尼对麻醉持续时间的影响。
The effect of adjuvant midazolam compared with fentanyl on the duration of spinal anesthesia with 0.5% bupivacaine in opium abusers.
机构信息
Department of Anesthesiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Korean J Anesthesiol. 2012 Dec;63(6):521-6. doi: 10.4097/kjae.2012.63.6.521. Epub 2012 Dec 14.
Abstract
BACKGROUND
There are a number of adjuvants to be used for local anesthetics in spinal block. The aim of this study was to demonstrate the possible effect of intrathecal midazolam compared with bupivacaine as adjuvants in spinal anesthesia with bupivacaine in chronic opium abuses.
METHODS
In a double blind, randomized clinical trial, 90 opium abuser patients undergoing lower limb orthopedic surgery were selected and randomly assigned into 3 groups (30 cases each). The patients received 15 mg plain bupivacaine, or 15 mg bupivacaine plus 25 mcg fentanyl or 15 mg bupivacaine plus 1 mg midazolam, intrathecally.
RESULTS
The duration of anesthesia was much longer in the bupivacaine-midazolam group than the bupivacaine-fentanyl group; both were longer than the plain bupivacaine group (P < 0.05).
CONCLUSIONS
Subarachnoid injection of adjuvant midazolam or fentanyl with plain 0.5% bupivacaine in opium abusers in lower limb orthopedic surgery increases the duration of sensory block. Therefore midazolam is more effective than fentanyl in such cases.
摘要
背景
局部麻醉中可以使用多种佐剂。本研究旨在证明鞘内给予咪达唑仑与布比卡因联合应用于慢性阿片滥用患者椎管内麻醉的可能效果。
方法
在一项双盲、随机临床试验中，选择了 90 名接受下肢骨科手术的阿片滥用患者，并将其随机分为 3 组（每组 30 例）。患者鞘内给予 15mg 布比卡因、15mg 布比卡因加 25mcg 芬太尼或 15mg 布比卡因加 1mg 咪达唑仑。
结果
布比卡因-咪达唑仑组的麻醉持续时间明显长于布比卡因-芬太尼组，均长于单纯布比卡因组（P<0.05）。
结论
在下肢骨科手术的阿片滥用患者中，蛛网膜下腔注射佐剂咪达唑仑或芬太尼与 0.5%布比卡因联合应用可延长感觉阻滞时间。因此，咪达唑仑在这种情况下比芬太尼更有效。
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