盐酸右美托咪定联合瑞芬太尼在骨科手术中的应用效果及对呼吸功能的影响  

Application Effect of Dexmedetomidine Hydrochloride Combined with Remifentanil in Orthopedic Surgery and Its Effect on Respiratory Function

作　　者：聂宇[1] 于健[1] 朱春花 王本清[1] 王雷[1] 王琰[1] Nie Yu;Yu Jian;Zhu Chunhua;Wang Benqing;Wang Lei;Wang Yan(Cangzhou Central Hospital,Cangzhou,061000)

机构地区：[1]沧州市中心医院,沧州061000

出　　处：《基因组学与应用生物学》2020年第1期343-348,共6页Genomics and Applied Biology

摘　　要：本研究考察了盐酸右美托咪定联合瑞芬太尼(观察组,n=68)和丙泊酚联合瑞芬太尼(对照组,n=68)在我院136例骨科手术患者中的应用效果,应用警觉/镇静观察评分(OAA/S)评价患者用药前(T0)、用药10 min后(T1)、用药20 min后(T2)、用药30 min后(T3)和清醒后(T4)的镇静效果,并比较了两组患者在不同时间点的呼吸频率(RR)、血氧饱和度(SpO2)、心率(HR)和平均动脉压(MAP)。研究结果显示,两组患者在T0、T1和T4时间点的OAA/S评分无统计学差异(p>0.05),观察组在T2和T3时间点的OAA/S评分明显小于对照组(p<0.05)。两组患者在T0、T1和T4时间点的RR无统计学差异(p>0.05),观察组在T2和T3时间点时的RR明显大于对照组(p<0.05)。观察组在T2时间点时的SpO2明显大于对照组(p<0.05)。两组患者的SpO2在其他时间段时无明显差异(p>0.05)。两组患者的HR和MAP均未表现出明显差异(p>0.05)。观察组的不良反应发生率为2.94%,明显高于对照组的11.76%(p=0.049)。本研究结论初步表明,与丙泊酚联合瑞芬太尼相比,盐酸右美托咪定联合瑞芬太尼在骨科手术中具有更好的镇静效果,可有效保障患者的呼吸功能,具有良好的血流动力学稳定性和安全性。This study investigated the application effect of dexmedetomidine hydrochloride combined with remifentanil(Observation group,n=68) and propofol combined with remifentanil(Control group,n=68) in 136 orthopedic surgery patients in our hospital.The sedative effect of patients before administration(T0),after 10 minutes of administration(T1),after 20 minutes of administration(T2),after 30 minutes of administration(T3),and after waking(T4) was evaluated by using the observer’s assessment of alertness/sedation(OAA/S),and the respiratory rate(RR),oxygen saturation(SpO2),heart rate(HR),and mean arterial pressure(MAP) at different time points were compared between the two groups.The study showed that there was no significant difference in the OAA/S scores between the two groups at the T0,T1,and T4 time points(p>0.05).The OAA/S scores of the observation group at the T2 and T3 time points were significantly smaller than those of the control group(p<0.05).There was no significant difference in RR between the two groups at T0,T1 and T4(p>0.05).The RR of the observation group at the T2 and T3 time points was significantly higher than that of the control group(p<0.05).The SpO2 of the observation group at the T2 time point was significantly larger than that of the control group(p<0.05).There was no significant difference in SpO2 between the two groups at other time points(p>0.05).There were no significant differences in HR and MAP between the two groups(p>0.05).The incidence of adverse reactions in the observation group was 2.94%,which was significantly higher than that in the control group(11.76%)(p=0.049).Our research conclusions preliminarily indicated that dexmedetomidine hydrochloride combined with remifentanil has a better sedative effect in orthopedic surgery compared with propofol combined with remifentanil,which can effectively protect patients’ respiratory function,and has good hemodynamic stability and safety.

关 键 词：骨科手术 镇静 盐酸右美托咪定 瑞芬太尼 丙泊酚 呼吸抑制 

分 类 号：R614[医药卫生—麻醉学]