右美托咪定预处理用于烧伤患者削痂植皮术中的镇痛镇静效果及应激反应的影响  

The Effect of Dexmedetomidine Pretreatment on the Analgesic and Sedative Effect and Stress Response of Patients with Burn During Scab Removal and Skin Grafting

作　　者：罗莹嘉 梁健 卓银芳 李皇清 LUO Yingjia;LIANG Jian;ZHUO Yinfang;LI Huangqing(Department of Anesthesiology,Meizhou Hospital of Traditional Chinese Medicine,Meizhou,Guangdong Province,514071 China)

机构地区：[1]梅州市中医医院麻醉科,广东梅州514071

出　　处：《系统医学》2021年第23期87-89,93,共4页Systems Medicine

摘　　要：目的探讨右美托咪定预处理用于烧伤患者削痂植皮术中的镇痛镇静效果及应激反应的影响。方法抽取2019年1月—2021年1月收治的60例烧伤患者,以随机数字表法分为观察组及对照组,各组30例,观察组于术前15 min给予右美托咪定1μg/kg,对照组于术前15 min给予等量生理盐水,对两组干预效果进行比较。结果两组T0时Ramsay镇静评分,差异无统计学意义(P>0.05);观察组T1~T3各时段Ramsay镇静评分分别为(2.75±0.62)分、(2.48±0.55)分、(2.31±0.51)分与对照组比较,差异有统计学意义(t=12.801、10.758、10.090,P<0.05);观察组术后4、8、12、24 h各时段VAS评分均较对照组低,差异有统计学意义(P<0.05);两组T0时HR、MAP水平差异无统计学意义(P>0.05),观察组T2、T3时HR、MAP水平与对照组相比,差异有统计学意义(P<0.05)。结论右美托咪定预处理用于烧伤患者削痂植皮术中镇静镇痛效果理想,可降低围术期应激反应,值得应用。Objective To investigate the analgesic and sedative effects of dexmedetomidine pretreatment for burn patients during scab removal and skin grafting and the influence of stress response.Methods Selected 60 burn patients admitted from January 2019 to January 2021,they were divided into observation group and control group by random number table method,30 cases in each group.The observation group was given dexmedetomidine 1μg/kg for 15 minutes before surgery,the control group was given the same amount of normal saline 15 minutes before the operation,compared the intervention effects of the two groups.Results There was no statistically significant difference in the Ramsay sedation scores between the two groups at T0(P>0.05).The Ramsay sedation scores of the observation group were(2.75±0.62)points,(2.48±0.55)points,and(2.31±0.51)points at each time period from T1 to T3 compared with the control group,the difference was statistically significant(t=12.801,10.758,10.090,P<0.05);the observation group had lower VAS scores at 4 h,8 h,12 h,and 24 h after surgery than the control group,the difference was statistically significant(P<0.05);at T0,there was no statistically significant difference in the levels of HR and MAP(P>0.05).The levels of HR and MAP at T2,and T3 in the observation compared with the control group,the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine pretreatment has ideal sedative and analgesic effects during scab removal and skin grafting in burn patients,and it can reduce the perioperative stress response and is worthy of application.

关 键 词：右美托咪定 烧伤患者 削痂植皮术 镇痛镇静 应激反应 

分 类 号：R726[医药卫生—儿科]