上肢骨折手术中应用咪达唑仑联合臂丛麻醉的效果及对认知功能的影响  

Effect of Midazolam Combined with Brachial Plexus Anesthesia in Upper Limb Fracture Surgery andits Effect on Cognitive Function

作　　者：裴文晖 PEI Wen-hui(Department of Anesthesiology,Yongfeng County Hospital of Traditional Chinese Medicine,Yongfeng 331500,Jiangxi,China)

机构地区：[1]永丰县中医院麻醉科,江西永丰331500

出　　处：《医学信息》2024年第18期128-131,共4页Journal of Medical Information

摘　　要：目的研究上肢骨折手术中应用咪达唑仑联合臂丛麻醉的效果及对认知功能的影响。方法选取2021年6月-2023年1月我院行上肢骨折手术的67例患者为研究对象,采用随机数字表法分为对照组(n=34)和观察组(n=33)。对照组采用臂丛麻醉,观察组采用咪达唑仑联合臂丛麻醉,比较两组临床麻醉效果(麻醉和运动阻滞起效时间、持续时间)、简易精神状态量表(MMSE)评分、Ramsay镇静评分、疼痛评分(VAS)、不同时间段动力学指标(心率、平均动脉压、血氧饱和度)、不良反应发生率。结果观察组麻醉和运动阻滞起效时间短于对照组,麻醉和运动阻滞持续时间大于对照组(P<0.05);两组术后第1天MMSE评分均低于术前,Ramsay评分均高于术前,但观察组MMSE评分高于对照组,Ramsay评分低于对照组(P<0.05);两组术后VAS评分均低于术前,且观察组低于对照组(P<0.05);两组麻醉后心率、平均动脉压、血氧饱和度均低于麻醉前,但观察组高于对照组(P<0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论上肢骨折手术中应用咪达唑仑联合臂丛麻醉效果良好,麻醉和运动阻滞起效时间短,对认知功能、血流动力学影响小,且不会增加不良反应发生率。Objective To study the effect of midazolam combined with brachial plexus anesthesia in upper limb fracture surgery and its effect on cognitive function.Methods A total of 67 patients who underwent upper limb fracture surgery in our hospital from June 2021 to January 2023 were selected as the research objects.They were divided into control group(n=34)and observation group(n=33)by random number table method.The control group was treated with brachial plexus anesthesia,and the observation group was treated with midazolam combined with brachial plexus anesthesia.The clinical anesthesia effect(onset time and duration of anesthesia and motor block),Mini-mental State Examination(MMSE)score,Ramsay sedation score,pain score(VAS),dynamic indexes at different time periods(heart rate,mean arterial pressure,oxygen saturation)and incidence of adverse reactions were compared between the two groups.Results The onset time of anesthesia and motor block in the observation group was shorter than that in the control group,and the duration of anesthesia and motor block was longer than that in the control group(P<0.05).The MMSE score of the two groups on the first day after operation was lower than that before operation,the Ramsay score was higher than that before operation,but the MMSE score of the observation group was higher than that of the control group,the Ramsay score was lower than that of the control group(P<0.05).The postoperative VAS score of the two groups was lower than that before operation,and that of the observation group was lower than that of the control group(P<0.05).The heart rate,mean arterial pressure and blood oxygen saturation of the two groups after anesthesia were lower than those before anesthesia,but those of the observation group were higher than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion Midazolam combined with brachial plexus anesthesia in upper limb fracture surgery has

关 键 词：上肢骨折手术 咪达唑仑 臂丛麻醉 麻醉效果 认知功能 

分 类 号：R683.41[医药卫生—骨科学]