[Effects of intravenous midazolam, fentanyl or ketamine on pain relief during performance of epidural anesthesia].
[Effects of intravenous midazolam, fentanyl or ketamine on pain relief during performance of epidural anesthesia].
复制标题
静脉注射咪达唑仑、芬太尼或氯胺酮对硬膜外麻醉镇痛效果的影响[J].
DOI：
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
T. Sata
中科院分区：
文献类型：
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作者：
Tadanori Terada;K. Hara;T. Sata
背景
实施硬膜外麻醉伴随着疼痛。本研究的目的是检查静脉注射镇静剂、阿片类药物或麻醉剂是否能消除硬膜外手术中的疼痛评分。
方法
将259例硬膜外麻醉患者随机分为6组。硬膜外麻醉前，每组患者均静脉注射咪达唑仑、芬太尼、氯胺酮、咪达唑仑+芬太尼或咪达唑仑+氯胺酮。术后采用视觉模拟评分(VAS)评定疼痛缓解效果。
结果
与未用药组相比，各用药组VAS均有不同程度的降低。药物治疗组之间差异无统计学意义。在这项研究中，没有观察到包括持续性呼吸抑制在内的严重副作用。
结论
本研究结果提示，药物的镇痛作用不是止痛所必需的，而抗焦虑作用在硬膜外手术中是重要的。
BACKGROUND
Performing epidural anesthesia is accompanied by pain. The aim of this study is to examine whether intravenous administration of a sedative, an opioid, or an anesthetic eliminates pain score during the epidural procedure.
METHODS
Two-hundred and fifty-nine patients undergoing epidural anesthesia were randomly allocated into six groups. Prior to the epidural anesthesia, midazolam, fentanyl, ketamine, midazolam plus fentanyl or midazolam plus ketamine was given intravenously to the patients in each group. After the procedure, the effects of these drugs on pain relief in the patients were assessed by visual analogue scale(VAS).
RESULTS
VAS was significantly decreased in all drug-treated groups to a similar extent, as compared with drug-free group. There was no significant difference between the drug-treated groups. Serious side effects including persistent respiratory suppression were not observed in this study.
CONCLUSIONS
The findings obtained from this study suggest that the analgesic action of the drug is not essential to the pain relief and the anxiolytic action is important for the epidural procedure.