比较地佐辛与咪达唑仑复合瑞芬太尼用于肝癌射频消融术患者麻醉的效果。

选择2013年1月至2016年6月择期行经皮肝穿刺射频消融术的肝癌患者48例，随机分为地佐辛组（Ⅰ组）和咪达唑仑组（Ⅱ组），各24例。Ⅰ组静脉注射地佐辛负荷量0.8 mg/kg，Ⅱ组静脉注射咪达唑仑负荷量0.05~0.1 mg/kg。负荷量注射完毕后5 min静脉注射瑞芬太尼负荷量0.2 μg/kg，然后静脉泵注瑞芬太尼0.05 μg/(kg·min）并开始手术，术中根据血流动力学调整瑞芬太尼给药速度。记录诱导前、诱导后、热疗中、退针、苏醒5个时间点的平均动脉压（MAP）、心律（HR）和围术期的不良反应。

两组诱导前、诱导后、热疗中、退针、苏醒5个时间点MAP（t=-1.929、0.315、1.380、1.604、0.463，P=0.061、0.754、0.176、0.117、0.063）和HR（t=-0.287、-0.280、-1.442、-0.766、0.683，P=0.775、0.781、0.158、0.448、0.489）的差异均无统计学意义。与Ⅱ组比较，Ⅰ组呼吸抑制发生率降低（χ²=6.857，P=0.022），苏醒即刻疼痛程度评分、术后1 h疼痛评分差异有统计学意义（t=2.534、4.376，P=0.020、0.000）。

肝癌射频消融术中地佐辛复合瑞芬太尼的麻醉效果优于咪达唑仑复合瑞芬太尼。

To compare the anesthetic effect of dezocine combined with remifentanil with midazolam combined with remifentanil for patients with liver cancer treated by radiofrequency ablation.

Forty-eight cases with liver cancer who received a percutaneous transhepatic radiofrequency ablation from January 2013 to June 2016 were randomly divided into 2 groups (24 cases in each group): dezocine group (GroupⅠ) and midazolam group (GroupⅡ). The patients in GroupⅠ were intravenously injected with dezocine at a load capacity of 0.8 mg/kg; GroupⅡwere intravenously injected with midazolam at a load capacity of 0.05-0.l mg/kg. In 5 minutes since the load capacity injection, the patients were intravenously injected with remifentanil at a load capacity of 0.2 μg/kg, then remifentanil was intravenously pumped at 0.05 μg/(kg·min) and the operation was started. The administration speed of remifentanil was adjusted according to hemodynamics during the operation. The mean arterial pressure (MAP), heart rate (HR) and perioperative adverse reaction before inducement, after inducement, during thermal therapy, withdrawal of needle and revival had been recorded.

The differences of MAP (t=-1.929, 0.315, 1.380, 1.604, 0.463, P=0.061, 0.754, 0.176, 0.117, 0.063) and HR (t=-0.287, -0.280, -1.442, -0.766, 0.683, P=0.775, 0.781, 0.158, 0.448, 0.489) between both groups were not statistically significant. Compared with Group Ⅱ, Group Ⅰ had a lowered occurrence rate of respiratory depression (χ²=6.857, P=0.022), and the difference in pain scoring upon revival and pain scoring 1 hour after operation was statistically significant (t=2.534, 4.376, P=0.020, 0.000).

Dezocine combined with remifentanil has better anesthetic effect than midazolam combined with remifentanil does when applied to patients undergoing liver cancer radiofrequency ablation.