右美托咪定镇静麻醉在急诊胫腓骨骨折手术中的应用效果观察  

Observation on application effect of dexmedetomidine sedative anesthesia in emergency tibial and fibular fracture surgery

作　　者：全芬 谢宇成 QUAN Fen;XIE Yu-cheng(Anaesthesiology,Shangrao People's Hospital,Shangrao 334000,China)

机构地区：[1]上饶市人民医院麻醉学,334000 [2]上饶市妇幼保健院麻醉学,334000

出　　处：《中国现代药物应用》2024年第3期101-103,共3页Chinese Journal of Modern Drug Application

摘　　要：目的分析右美托咪定镇静麻醉在急诊胫腓骨骨折手术中的应用效果及安全性。方法70例急诊行胫腓骨骨折手术的患者,将其随机分为观察组及对照组,每组35例。观察组给予右美托咪定静脉镇静麻醉,对照组给予舒芬太尼联合硬膜外麻醉。比较两组患者不同时间(术后上泵即刻及术后30 min、1 h、2 h、3 h、6 h、12 h、24 h、36 h、48 h)、状态(静息、运动状态)的视觉模拟评分法(VAS)评分;拔管后5 min镇静评分;拔管时呛咳评分;不良反应发生状态情况。结果观察组患者术后30 min、1 h、2 h、3 h、6 h、12 h、24 h、36 h、48 h以及静息、运动状态的VAS评分分别为(5.26±1.12)、(5.00±0.73)、(5.49±1.15)、(5.74±1.52)、(7.26±0.85)、(5.23±0.84)、(4.29±0.83)、(4.00±0.73)、(2.51±0.51)、(2.23±0.43)、(2.77±0.84)分,均低于对照组的(6.71±1.32)、(6.29±0.83)、(5.97±0.71)、(6.46±0.85)、(8.03±0.71)、(6.49±0.51)、(4.80±1.08)、(4.51±0.51)、(3.26±0.44)、(3.03±0.71)、(3.54±1.12)分,差异具有显著性统计学意义(P<0.05)。观察组患者拔管后5 min镇静评分(4.29±0.75)分、拔管时呛咳评分(2.37±0.97)分低于对照组的(4.91±0.70)、(2.83±0.79)分,差异具有统计学意义(P<0.05)。观察组恶心、呕吐、瘙痒、呼吸抑制发生率分别为2.5%、5.0%、7.5%、5.0%,均低于对照组的37.5%、40.0%、30.0%、40.0%,差异具有统计学意义(P<0.05)。结论右美托咪定对于急诊胫腓骨骨折手术安全性高,不良反应少,值得临床推荐应用。Objective To analyze the safety of dexmedetomidine sedative anesthesia in emergency tibial and fibular fracture surgery.Methods 70 patients undergoing emergency tibial and fibular fracture surgery were randomly divided into an observation group and a control group,with 35 patients in each group.The observation group received intravenous sedative anesthesia with dexmedetomidine,and the control group received epidural anesthesia with sufentanil.Comparison was made on the visual analogue scale(VAS)score at different time points(immediately,30 min,1 h,2 h,3 h,6 h,12 h,24 h,36 h,and 48 h after surgery)and different states(at rest and during activity),sedation scores at 5 min after extubation,cough score at extubation,and adverse reactions between the two groups.Results In the observation group,the VAS scores at 30 min,1 h,2 h,3 h,6 h,12 h,24 h,36 h,and 48 h after surgery,at rest and during activity were(5.26±1.12),(5.00±0.73),(5.49±1.15),(5.74±1.52),(7.26±0.85),(5.23±0.84),(4.29±0.83),(4.00±0.73),(2.51±0.51),(2.23±0.43),(2.77±0.84)points,which were lower than(6.71±1.32),(6.29±0.83),(5.97±0.71),(6.46±0.85),(8.03±0.71),(6.49±0.51),(4.80±1.08),(4.51±0.51),(3.26±0.44),(3.03±0.71),(3.54±1.12)points in the control group,and the difference was statistically significant(P<0.05).The sedation score at 5 min after extubation in the observation group was(4.29±0.75)points and the cough score at extubation was(2.37±0.97)points,which were lower than(4.91±0.70)and(2.83±0.79)points in the control group,and the difference was statistically significant(P<0.05).The incidence rates of nausea,vomiting,itching and respiratory depression in the observation group were 2.5%,5.0%,7.5%and 5.0%,which were lower than 37.5%,40.0%,30.0%and 40.0%in the control group,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine is highly safe and has less adverse reactions for emergency tibial and fibula fracture surgery,which is worthy of clinical recommendation.

关 键 词：右美托咪定 镇静麻醉 胫腓骨骨折手术 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]