静脉快通道麻醉联合咪达唑仑超前镇静在军队伤病员膝关节损伤行手术治疗中的效果观察  

Effects of Midazolam advanced sedation combined with intravenous fast-track anesthesia on military patients undergoing surgery for knee injury

作　　者：张东峰 朱明达 冯军贤 景调平 李泽仁 ZHANG Dongfeng;ZHU Mingda;FENG Junxian;JING Tiaoping;LI Zeren(Department of Purchasing Management,No.942 Hospital,Joint Support Force of the People’s Liberation Army,Yinchuan,Ningxia 750004,China;Department of Anesthesiology,No.942 Hospital,Joint Support Force of the People’s Liberation Army,Yinchuan,Ningxia 750004,China)

机构地区：[1]中国人民解放军联勤保障部队第九四二医院采购管理科,宁夏银川750004 [2]中国人民解放军联勤保障部队第九四二医院麻醉科,宁夏银川750004

出　　处：《医药前沿》2023年第10期19-21,共3页Journal of Frontiers of Medicine

基　　金：中国国人民解放军联勤保障部队第九四二医院新技术基金(D942JSYW2020003)。

摘　　要：目的:观察静脉快通道麻醉联合咪达唑仑超前镇静对于军队伤病员膝关节损伤行手术治疗伤中的效果观察。方法:选取拟行膝关节手术治疗的军队伤病员60例,均通过焦虑自评量表(SAS)分级为中等焦虑程度。将其随机分为D组与M组,每组各30例。D组在麻醉前30 min肌肉注射0.9%氯化钠溶液,M组在麻醉前30 min肌肉注射咪达唑仑注射液,观察并记录两组全麻诱导时(T_(1))、术中触碰骨膜或软骨膜时(T_(2))、术毕缝皮时(T_(3))患者的心率(HR),平均动脉压(MAP);对两组3个时间点的T_(1)、T_(3) pH值、血糖值以及血乳酸进行检测。结果:3个时间点,两组伤病员MAP、HR组间比较,差异无统计学意义(P>0.05)。pH值:T_(1)时两组比较,差异无统计学意义(P>0.05);T_(2)、T_(3)时M组>D组,差异有统计学意义(P<0.05);血糖值:两组伤病员在T_(1)时较T_(2)、T_(3)时低,T_(2)时,D组较M组低,差异均有统计学意义(P<0.05),但两组T_(1)、T_(3)时间点组间比较,差异无统计学意义(P>0.05);血乳酸值:T_(1)时两组比较,差异无统计学意义(P>0.05),T_(2)、T_(3)时血乳酸值D组>M组(P<0.05)。结论:静脉快通道麻醉联合咪达唑仑超前镇静在军队伤病员膝关节损伤行手术治疗效果显著,循环功能稳定,利于患者术后康复。Objective To investigate the effect of Midazolam advanced sedation combined with intravenous fast-track anesthesia on military patients undergoing surgery for knee injury.Methods 60 of military wounded and sick who underwent knee operation were selected.They were divided into preoperative intravenous injection of normal saline(D)group and preoperative intramuscular injection of Midazolam(M)group by different ways of use.According to random number table method,30 patients in each group.The Heart rate(HR),Mean arterial pressure(MAP)of the patients were observed and recorded after induction of general anesthesia(T_(1)),when periosteum or perichondrium was touched intraoperatively(T_(2)),and after cutaneous suture(T_(3)).Blood gas analysis was performed at these three time points,and blood gas analysis results(including pH value,blood glucose value and blood lactic acid value)were recorded.Results At the three time points,there was no significant difference in MAP and HR between the two groups(P>0.05).pH value:There was no difference between the two groups at T_(1)(P>0.05);At T_(2) and T_(3),M group was higher than D group(P<0.05);Blood glucose value:T_(1) in the 2 groups was lower than T_(2) and T_(3),and there were statistical differences in blood glucose between the two groups(P<0.05),but there were no differences between the two groups at each time point(P>0.05).Blood lactic acid value:there was no significant difference among the two groups at T_(1)(P>0.05),and blood lactic acid value at T_(2) and T_(3) was higher in group D than those in group M(P<0.05).Conclusion Midazolam advanced sedation combined with intravenous fast-track anesthesia has little disturbance to homeostasis in military patients undergoing arthroscopic knee surgery,which is beneficial to postoperative rehabilitation of patients.

关 键 词：超前镇静 咪达唑仑 抗焦虑 应激 静脉快通道麻醉 

分 类 号：R543.6[医药卫生—心血管疾病]