咪达唑仑预处理对地塞米松磷酸钠引起会阴部瘙痒的影响

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目的:观察咪达唑仑(midazolam, MDZ)预处理对抑制地塞米松磷酸钠注射液引起会阴部瘙痒的有效性。方法:行择期手术的患者120例,年龄18~64岁,ASA分级Ⅰ、Ⅱ级,BMI 18~30 kg/mn 2,按随机数字表法将患者分为咪达唑仑组(M组)和对照组(C组),每组60例。M组患者麻醉诱导前静脉注射0.03 mg/kg MDZ, C组患者则相应给予等容量生理盐水,1 min后两组患者均静脉注射地塞米松磷酸钠注射液10 mg。记录两组患者出现会阴部瘙痒发生率、持续时间、VAS评分、四分口头等级评分量表(Verbal Rating Scale, VRS)分级,记录两组患者Ramsay镇静评分,观察患者头晕、低血压、呼吸抑制等不良反应的发生情况。n 结果:与C组比较,M组患者会阴部瘙痒发生率、瘙痒VAS评分、VRS分级中、重度瘙痒占比降低(n P<0.05),瘙痒持续时间缩短(n P<0.05),Ramsay镇静评分升高(n P<0.05)。C组中,女性患者瘙痒发生率、持续时间、VRS分级重度瘙痒占比高于男性患者(n P<0.05 );男性患者中,M组瘙痒发生率低于C组(n P<0.05 );女性患者中,M组瘙痒发生率、持续时间、VAS评分、VRS分级重度瘙痒占比低于C组(n P0.05 )。n 结论:MDZ可有效抑制地塞米松磷酸钠注射液引起的会阴部瘙痒且无其他明显不良反应发生。“,”Objective:To investigate the effects of midazolam (MDZ) pretreatment on perineal pruritus induced by dexamethasone sodium phosphate injection.Methods:A total of 120 patients scheduled for surgery, aged 18-64 years, American Society of Anesthesiologists (ASA) grades Ⅰ or Ⅱ, body mass index (BMI) 18-30 kg/mn 2 were selected in this study. According to the random number table method, the patients were divided into two groups (n n=60): a midazolam group (group M) and a control group (group C). Before anesthesia induction, group M was intravenously injected with 0.03 mg/kg MDZ, while group C was given an equal volume of normal saline. Then, 1 min later, both groups were intravenously injected with dexamethasone sodium phosphate injection (10 mg). Their perineal pruritus was evaluated. The number of pruritus patients, the starting and duration of pruritus, Visual Analogue Scale (VAS) scores, the 4-point Verbal Rating Scale (VRS) scores were recorded. The Ramsay sedation scores were recorded and adverse reactions such as dizziness, hypotension and respiratory depression were observed in the two groups.n Results:Compared with group C, patients in group M presented remarkable decreases in the incidence and duration of pruritus, VAS score, and the percentage of moderate and severe pruritus of VRS scores, as well as increases in Ramsay scores (n P<0.05). In group C, the incidence of pruritus, duration of pruritus, and proportion of severe pruritus in the female were higher than those in the male (n P<0.05). In male patients, the incidence of pruritus in group M was lower than that in group C (n P<0.05), and in female patients, the incidence of pruritus, duration of pruritus, VAS score and proportion of severe pruritus graded by VRS in group M were lower than that in group C (n P0.05).n Conclusions:MDZ can effectively inhibit perineal pruritus induced by dexamethasone sodium phosphate injection, without obvious adverse reactions.
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