丙泊酚联合右美托咪定靶控输注在烧伤休克期的麻醉效果  

Anesthetic Effect of Target Controlled Infusion of Propofol Combined with Dexmedetomidine at the Shock Stage of Burns

作　　者：李瑞科 崔晓林[2] 

机构地区：[1]河南省原阳县第二人民医院麻醉科,河南新乡453500 [2]武警辽宁省总队医院烧伤科,辽宁沈阳110034

出　　处：《中国烧伤创疡杂志》2015年第6期387-391,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的探讨丙泊酚联合右美托咪定靶控输注在严重烧伤休克期的麻醉效果。方法将急诊收治的38例严重烧伤休克期患者按照随机抽签原则分为治疗组(20例)与对照组(18例)。两组患者均采用靶控输注静脉全麻,对照组选择丙泊酚麻醉,治疗组选择丙泊酚加右美托咪定麻醉。结果两组患者不同时间点的心率均维持在正常范围,差异均无统计学意义;治疗组患者麻醉诱导后的动脉压明显高于对照组(P<0.05)。两组患者麻醉诱导后的血清TNF-α和IL-6值均明显升高(P<0.05),随后治疗组逐渐恢复正常,而对照组继续维持高位,组间对比,差异具有统计学意义(P<0.05)。术后,治疗组的呼吸抑制、恶心呕吐、精神症状、肢体运动障碍等不良反应发生情况明显低于对照组(P<0.05)。结论严重烧伤休克期应用丙泊酚联合右美托咪定靶控输注安全可靠,能有效保持麻醉效果,并能减轻炎症反应及不良反应发生率。Objective To explore the anesthetic effects of target controlled infusion of Propofol and Dexmedetomidine at the shock stage of severe burns.Methods Thirty-eight patients with severe burns at the shock stage admitted into the emergency department were divided into a treatment group（20 patients） and a control group（18 patients） according to random lot-drawing.Intravenous anesthesia of target controlled infusion was adopted in the both groups but the control group was only given Propofol and the treatment group was given Propofol plus Dexmedetomidine.Results Heart rates of patients at different time points in the two groups were maintained at the normal range,with no significant statistical difference.The arterial pressure after the anesthesia in the treatment group was significandy higher than that in the control group（P〈0.05）.The serum TNF-α and IL-6 obviously increased after the anesthesia in the both groups but they gradually returned to normal in the treatment group;in contrast,they still kept at a higher level without falling in the control group and the between-group comparison showed statistically significant difference（P〈0.05）.After the operation,the occurrence of adverse reactions such as respiratory depression,nausea and vomiting,mental symptoms,limb movement disorders and etc.in the treatment group was obviously less than that in the control group（P〈0.05）.Conclusion The application of target controlled infusion of Propofol combined with Dexmedetomidine at the shock stage of severe burns is safe and effective since not only can anesthetic effect be effectively kept,and also the incidences of inflammatory responses and adverse reactions can be reduced.

关 键 词：丙泊酚 右美托咪定 靶控输注 烧伤休克期 麻醉 

分 类 号：R614[医药卫生—麻醉学]