咪达唑仑联合瑞芬太尼对接受手术后的重度颅脑损伤患者进行镇痛镇静治疗的效果  

Efficacy of midazolam combined with remifentanil in analgesic sedation of patients with severe craniocerebral injury after surgery

作　　者：范诚 方理超[1] FAN Cheng;FANG Lichao(Department of Critical Care Medicine,Xiangcheng People’s Hospital of Suzhou,Suzhou 215131,China)

机构地区：[1]江苏省苏州市相城人民医院重症医学科,江苏苏州215131

出　　处：《当代医药论丛》2022年第22期131-133,共3页

基　　金：苏州市科技计划项目,编号:SYS2019015。

摘　　要：目的:探究咪达唑仑联合瑞芬太尼对接受手术后的重度颅脑损伤患者进行镇痛镇静治疗的效果。方法:抽取2019年1月至2021年10月在苏州市相城人民医院行重度颅脑损伤治疗的105例患者作为样本对象。依据术后镇痛方式的区别分为对照组(52例)和观察组(53例)。对照组予以咪达唑仑,观察组则予以咪达唑仑联合瑞芬太尼。比对评估两组对象的镇静评分以及血流动力学指标。结果:镇痛治疗后,观察组的RASS评分〔(4.74±1.42)分〕高于对照组〔(3.11±1.23)分〕,SAS评分〔(3.08±0.68)分〕低于对照组〔(4.81±0.75)分〕,差异有统计学意义(t/P:-6.282/<0.001;12.387/<0.001);且该组的MAP、CVP及HR均低于对照组(P<0.001)。结论:在重度颅脑损伤手术后实施瑞芬太尼联合咪达唑仑镇痛治疗的效果显著,能有效改善患者的血流动力学指标,缓解脑部供血异常问题,快速达到镇痛、镇静效果。Objective:To explore the analgesic and sedative effects of midazolam combined with remifentanil on patients with severe craniocerebral injury after surgery.Methods:A total of 105 patients receiving treatment for severe craniocerebral injury in Xiangcheng People’s Hospital of Suzhou from January 2019 to October 2021 were selected as sample objects.According to the difference of postoperative analgesia,they were divided into control group(52 cases)and observation group(53 cases).The control group was given midazolam,and the observation group was given midazolam combined with remifentanil.The sedation scores and hemodynamic indexes of the two groups were compared and evaluated.Results:After analgesic treatment,RASS score(4.74±1.42)in the observation group was higher than that in the control group(3.11±1.23),SAS score(3.08±0.68)was lower than that in the control group(4.81±0.75),and the difference was statistically significant(t/P:-6.282/<0.001;12.387/<0.001);The MAP,CVP and HR in this group were lower than those in the control group(P<0.001).Conclusion:Remifentanil combined with midazolam has significant analgesic effect after severe craniocerebral injury surgery,which can effectively improve the hemodynamic indexes of patients,alleviate the problem of abnormal blood supply to the brain,and quickly achieve analgesic and se dative effects.

关 键 词：重度颅脑损伤 术后镇静镇痛 咪达唑仑 瑞芬太尼 镇静评分 血流动力学 

分 类 号：R651.15[医药卫生—外科学]