右美托咪啶术中辅助镇静对椎管内麻醉踝关节骨折患者术后睡眠质量的影响  

Effect of Dexmedetomidine Intraoperative Assisted Sedation on Postoperative Sleep Quality of Patients with Ankle Joint Fractures after Intraspinal Anesthesia

作　　者：程章仁 曹剑 魏海翔 游敏 陈华梁 CHENG Zhangren;CAO Jian;WEI Haixiang;YOU Min;CHEN Hualiang(The First Hospital of Nanping City,Fujian Province,Nanping 353000,China)

机构地区：[1]南平市第一医院,福建南平353000

出　　处：《中国医药指南》2022年第27期75-77,共3页Guide of China Medicine

摘　　要：目的 分析右美托咪啶术中辅助镇静对椎管内麻醉踝关节骨折患者术后睡眠质量产生的影响。方法 观察对象为2022年1月至2022年6月间在我院行椎管内麻醉的60例踝关节骨折患者,随机分成两组,即右美托咪定组(试验组,n=30例)和0.9%氯化钠组(对照组,n=30例)。患者术前均用匹兹堡睡眠质量(PSQI)进行评分,同时佩戴小米手环。患者入手术室腰硬联合麻醉稳定后,即给予试验组右美托咪定负荷剂量1μg/kg(15 min内泵注完毕),维持量以0.4μg/(kg·h)继续泵注至手术结束前30 min;对照组以等量0.9%氯化钠溶液输注。评估术前1天、术后第2天的睡眠质量,对比两组患者结果,并记录术后Ramsay评分、VAS评分、恶心呕吐发生率等。结果 ①不同组患者术前术后PSQI评分的对比:术前两组患者PSQI评分比较无差异(P> 0.05)。②术前两组患者总睡眠时间及觉醒次数比较无差异(P> 0.05),术后两组患者总睡眠时间及觉醒次数术均有所改善,但试验组改善更明显(P <0.05)。③术前两组的应激指标对比并无差异(P> 0.05);术后两组患者应激指标较术前均有所改善,但试验组改善更明显(P <0.05)。④试验组术后当天及术后第2天时Ramsay评分高于对照组、VAS评分低于对照组、恶心呕吐发生率低于对照组,差异具有统计学意义(P <0.05)。结论 右美托咪啶用于术中辅助镇静对椎管内麻醉踝关节骨折患者可产生良好影响,如提高术后睡眠质量、良好的镇静镇痛作用、稳定应激指标降低术后恶心呕吐发生率等,应用前景广阔。Objective To analyze the effect of dexmedetomidine assisted sedation on postoperative sleep quality of patients with ankle fractures after intraspinal anesthesia. Methods Observation objects were 60 patients with ankle fractures who underwent intraspinal anesthesia in our hospital from January 2022 to June 2022. They were randomly divided into 2 groups, namely dexmedetomidine group(experimental group, n=30 cases) and 0.9%sodium chloride group(control group, n=30 cases). The patients were scored by Pittsburgh Sleep Quality(PSQI) before the operation, and they also wore a Mi Band. After entering the operating room with combined spinal-epidural anesthesia, the experimental group was given a loading dose of 1 μg/kg of dexmedetomidine(the pumping was completed within 15 minutes), and the maintenance dose was continued to be pumped at 0.4 μg/(kg·h)until 30 minutes before the end of the operation. The control group was infused with an equal amount of 0.9% sodium chloride solution. To assess the sleep quality of the day before surgery, the first and second days after surgery, compare the results of the two groups of patients, and record the postoperative Ramsay score, VAS score, and the occurrence of nausea and vomiting Rate etc. Results(1)There was no difference in PSQI scores between the two groups before operation(P>0.05).(2) There was no significant difference in total sleep time and wakefulness times between the two groups before operation(P>0.05). After operation, the total sleep time and wakefulness times of the two groups were improved, but the improvement was more obvious in the experimental group(P<0.05).(3) There was no significant difference in the stress indexes between the two groups before operation(P>0.05), and the stress indexes in the two groups were improved after operation, but the improvement was more obvious in the experimental group(P<0.05).(4) Ramsay score was higher, VAS score was lower and the incidence of nausea and vomiting in the experimental group were lower in the control group on the da

关 键 词：右美托咪啶 镇静 椎管内麻醉 踝关节骨折 睡眠质量 

分 类 号：R683.4[医药卫生—骨科学] R614[医药卫生—外科学]