右美托咪定与咪达唑仑用于四肢手术镇静的效果比较  

Effect Comparison of Dexmedetomidine and Midazolam for Sedation in Extremities Surgery

作　　者：罗南英 Luo Nanying(Department of Anesthesiology, Affiliated Hospital of Sichuan Nursing Vocational College·The Third People's Hospital of Sichuan Province, Chengdu 610100, China)

机构地区：[1]四川护理职业学院附属医院·四川省第三人民医院麻醉科,成都610100

出　　处：《成都医学院学报》2021年第4期504-507,共4页Journal of Chengdu Medical College

摘　　要：目的观察右美托咪定与咪达唑仑应用于硬膜外麻醉和神经阻滞麻醉中对患者呼吸循环的影响及镇静效果,比较右美托咪定和咪达唑仑在四肢手术麻醉辅助镇静中的优势。方法选取2018年3月至2019年8月于四川护理职业学院附属医院行四肢择期手术患者80例为研究对象,按照随机数字表法分为右美托咪定组和咪达唑仑组,每组40例。记录并比较用药后两组患者心率(HR)、无创血压(NIBP)、血氧饱和度(SpO2)、呼吸频率(R)的变化及术中Ramsay镇静评分。结果右美托咪定组HR下降较咪达唑仑组明显(P<0.05),但两组患者均未出现心动过缓,无临床意义;两组NIBP变化比较,差异无统计学意义(P>0.05);咪达唑仑组SpO2下降较右美托咪定组明显(P<0.05);咪达唑仑组R下降较右美托咪定组明显(P<0.05);右美托咪定组Ramsay镇静评分3~4分者明显多于咪达唑仑组(P<0.05)。结论在四肢手术麻醉辅助镇静时,右美托咪定镇静深度较咪达唑仑更满意,且右美托咪定对呼吸系统功能影响小,麻醉管理更加安全方便,术毕患者无嗜睡,无术后呼吸抑制和缺氧风险。Objective To observe the effect of dexmedetomidine and midazolam on respiratory circulation and sedation in epidural anesthesia and nerve block anesthesia,and to compare the superiority of dexmedetomidine and midazolam in anesthesia-assisted sedation in extremity surgery.Methods A total of 80 patients who underwent elective extremity surgery in the Affiliated Hospital of Sichuan Nursing Vocational College from March 2018 to August 2019 were selected as the research subjects.They were divided into dexmedetomidine group(n=40)and midazolam group(n=40)according to random number table method.After medication,the changes of heart rate(HR),non-invasive blood pressure(NIBP),blood oxygen saturation(SpO2),and respiratory rate(R),and intraoperative Ramsay sedation score were recorded and compared between the two groups.Results HR decreased significantly in dexmedetomidine group compared with midazolam group(P<0.05).There was no bradycardia occurred in the two groups,which was not clinically significant.There was no significant difference in NIBP between the two groups(P>0.05).Both SpO2 and R decreased more significantly in midazolam group than in dexmedetomidine group(P<0.05).As to Ramsay sedation score,there were more cases scored 3-4 points in dexmedetomidine group than in midazolam group(P<0.05).Conclusion In anesthesia-assisted sedation in extremity surgery,compared with midazolam,dexmedetomidine leads to a more satisfactory sedation depth,less impact on respiratory function,safer and more convenient anesthesia management,and no post-operative drowsiness,respiratory depression or hypoxia risk.

关 键 词：右美托咪定 咪达唑仑 四肢手术 镇静 

分 类 号：R614[医药卫生—麻醉学]