老年中重度烧伤患者切痂植皮术中使用右美托咪定联合咪达唑仑的麻醉效果  

The Anesthesia Effect of Dexmedetomidine Combined with Midazolam in Elderly Patients with Moderate to Severe Burns Undergoing Scab Excision and Skin Grafting Surgery

作　　者：王海军[1] WANG Haijun(Department of Anesthesiology,Second People's Hospital of Huangchuan County,Xinyang Henan 465150)

机构地区：[1]河南省信阳市潢川县第二人民医院麻醉科,河南信阳465150

出　　处：《医学临床研究》2024年第9期1335-1338,共4页Journal of Clinical Research

摘　　要：【目的】探讨老年中重度烧伤患者切痂植皮术中使用右美托咪定(Dex)联合咪达唑仑的麻醉效果。【方法】102例老年中重度烧伤患者,随机分为观察组和对照组,每组51例。对照组采用丙泊酚维持麻醉,观察组采用Dex联合咪达唑仑维持麻醉。比较两组术中及术后不同时间点的心率(HR)、平均动脉压(MAP)水平;比较两组患者手术情况及手术前后血浆皮质醇(COR)、肾上腺素(E)、去甲肾上腺素(NE)水平;比较两组患者术后疼痛[视觉模拟评分法(VAS)]、镇静效果(Ramsay镇静评分)、躁动发生率及不良反应发生情况。【结果】观察组手术结束时、拔管前及拔管后30 min HR均低于对照组(P<0.05),MAP均高于对照组(P<0.05)。术后30 min时,观察组血浆COR、E、NE水平均低于对照组(P<0.05)。观察组VAS评分低于对照组(P<0.05),Ramsay镇静评分高于对照组(P<0.05),躁动发生率低于对照组(P<0.05)。观察组的苏醒时间短于对照组(P<0.05),两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】Dex联合咪达唑仑应用在老年中重度烧伤患者切痂植皮术中,能有效减轻患者术后应激反应,稳定血流动力学,缩短苏醒时间,减少术后疼痛,降低躁动发生率,且安全性较好。【Objective】To investigate the anesthetic effect of dexmedetomidine(Dex)combined with midazolam in elderly patients with severe burns undergoing scab excision and skin grafting surgery.【Methods】A total of 102 elderly patients with moderate to severe burns were randomly divided into the observation group and the control group,with 51 cases in each group.The control group was maintained with propofol anesthesia,while the observation group was maintained with Dex combined with midazolam anesthesia.The heart rate(HR)and mean arterial pressure(MAP)levels were compared between two groups at different time points during and after surgery;Two groups of patients were compared in terms of surgical conditions and plasma cortisol(COR),adrenaline(E),and norepinephrine(NE)levels before and after surgery;Two groups of patients were compared in terms of postoperative pain[visual analog scale(VAS)],sedation effect(Ramsay sedation score),agitation incidence,and incidence of adverse reactions.【Results】The HR of the observation group was lower than that of the control group at the end of surgery,before extubation,and 30 minutes after extubation(P<0.05),while the MAP was higher than that of the control group(P<0.05).At 30 minutes postoperatively,the plasma levels of COR,E,and NE in the observation group were lower than those in the control group(P<0.05).The VAS score of the observation group was lower than that of the control group(P<0.05),the Ramsay sedation score was higher than that of the control group(P<0.05),and the incidence of agitation was lower than that of the control group(P<0.05).The awakening time of the observation group was shorter than that of the control group(P<0.05),and there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).【Conclusion】Dex combined with midazolam can effectively reduce postoperative stress response,stabilize hemodynamics,shorten recovery time,reduce postoperative pain and agitation incidence in elderly patients with mod

关 键 词：烧伤/外科学 皮肤移植 右美托咪定/治疗应用 咪达唑仑/治疗应用 麻醉 

分 类 号：R644[医药卫生—外科学]