【摘要】目的观察硬膜外麻醉前静注小剂量咪达唑仑,对剖宫产产妇的抗焦虑、抗应激反应的影响,以及对新生儿是否有不良影响。方法选择单胎足月妊娠产妇80例。根据咪达唑仑用量随机将患者分为四组,每组20例。Mo组为对照组,静注生理盐水2ml;、、。5min之后行硬膜外麻醉。观察记录注药前(T1)、注药后5min(T2)、15min(T3)、30min(T4)产妇的脉搏血氧饱和度(SpO2)、呼吸(RR)、平均动脉压(MAP)、心率(HR)变化。观察注药前、注药后30min(划皮前)产妇焦虑视觉类比试验(AVAT)、血糖、皮质醇变化。观察胎儿娩出后1、5min Apgar评分、术后1d的新生儿神经与适应能力(NACS)评分。结果四组产妇呼吸循环功能稳定,M3组焦虑视觉类比试验用药后评分下降,血糖、皮质醇低于其他组。四组新生儿1、5min Apgar评分、术后1d的NACS无明显差异。结论硬膜外麻醉前静注小剂量咪达唑仑, 对剖宫产产妇有良好的抗焦虑及应激反应作用,对新生儿无不良影响。。 【关键词】咪达唑仑剖宫产术前用药应激反应皮质醇 【Abstract】 Objective To observe the antianxiety and anti-stress reaction effects of intravenous injection of a small dose of Midazolam on puerperants as preanesthetic medication before epidural anesthesia in uterine-incision delivery operation. Methods 80 puerperants with pregnancy at term and single birthed were randomly divided into 4 groups with 20 each . M0 group as control , intravenous injection of 2ml normal sodium ;in M1 group, intravenous injection of Midazolam; in M2 group, intravenous injection of Midazolam; in M3 group, intravenous injection of Midazolam. Then epidural anesthesia was performed 5 min later . The change of a saturation of blood oxygen (SPO2)、respiration rate (RR)、mean arterial pressure(MAP)、heart rate(HR)before drug administration(T1)、and 5 min (T2)、15min (T3)、30min(T4)after drug administration were recorded . Anxiety visual analog test(AVAT)、serum glucose 、hydrocortisone were lower than those in the other groups . There were not significant difference between Apgar score of 1 and 5 min 、neurological and adaptive capacity score(NACS) 1 day after operation in the 4 groups of newborn. Conclusions Intravenous injection of small dose Midazolam before epidural anesthesia has a good antianxiety and anti-stress reaction effects on puerperants as preanesthetic medication in uterine-incision delivery operation , there is no sid
