摘要
目的研究右美托咪定复合小剂量咪唑安定与单纯咪唑安定在慢诱导气管插管时对患者镇静程度的影响。方法选取2020年5月-2021年5月在我院行慢诱导气管插管的82例患者为研究对象,采用随机数字表法分为对照组和观察组,各41例。对照组采用单纯咪唑安定进行麻醉诱导,观察组采用右美托咪定复合小剂量咪唑安定进行麻醉诱导。比较两组自主呼吸恢复时间、睁眼时间、恢复指令时间、拔管时间、侵入性反应操作评分、不同时间段心率、收缩压以及舒张压水平、镇静评分、简易精神状态(MMSE)评分、蒙特利尔认知(MoCA)评分以及不良反应发生情况。结果观察组自主呼吸恢复时间、睁眼时间、恢复指令时间均短于对照组(P<0.05);观察组放置喉镜时、气管插管时侵入性反应操作评分均低于对照组(P<0.05);两组预充氧时心率、收缩压及舒张压比较,差异无统计学意义(P>0.05);观察组放置喉镜、气管插管时心率、收缩压及舒张压均低于对照组,但差异无统计学意义(P>0.05);观察组放置喉镜时、气管插管时镇静评分均低于对照组(P<0.05);拔管后,观察组MMSE评分、MoCA评分低于术前,但差异无统计学意义(P>0.05),对照组MMSE评分、MoCA评分低于术前(P<0.05),且观察组高于对照组(P<0.05);观察组不良反应发生率为7.32%,低于对照组的17.07%(P<0.05)。结论右美托咪定复合小剂量咪唑安定对慢诱导气管插管具有良好的镇静作用,可减小患者对气管插管的应激反应,促进患者术后苏醒,降低镇静评分,实现较良好的镇静效果,可减轻对生命体征影响,避免对认知功能造成损伤,具有相对更优的耐受性和安全性。
Objective To study the effect of dexmedetomidine combined with low-dose midazolam and simple midazolam on the degree of sedation during slow induction tracheal intubation.Methods A total of 82 patients who underwent slow induction tracheal intubation in our hospital from May 2020 to May 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,with 41 cases in each group.The control group was treated with simple midazolam for anesthesia induction,and the observation group was treated with dexmedetomidine combined with low-dose midazolam for anesthesia induction.The spontaneous breathing recovery time,eye opening time,recovery instruction time,extubation time,invasive reaction operation score,heart rate,systolic blood pressure and diastolic blood pressure at different time periods,sedation score,mini-mental state examination(MMSE)score,Montreal cognitive assessment(MoCA)score and adverse reactions were compared between the two groups.Results The spontaneous breathing recovery time,eye opening time and recovery command time in the observation group were shorter than those in the control group(P<0.05).The operation scores of invasive reaction during laryngoscopy placement and endotracheal intubation in the observation group were lower than those in the control group(P<0.05).There was no significant difference in heart rate,systolic blood pressure and diastolic blood pressure between the two groups during preoxygenation(P>0.05).The heart rate,systolic blood pressure and diastolic blood pressure of the observation group were lower than those of the control group when laryngoscope and tracheal intubation were placed,but the differences were not statistically significant(P>0.05).The sedation scores during laryngoscopy placement and endotracheal intubation in the observation group were lower than those in the control group(P<0.05).After extubation,the MMSE score and MoCA score of the observation group were lower than those before operation,but the difference was not statistically significant(P>0.05).The MMSE score and MoCA score of the control group were lower than those before operation(P<0.05),and the observation group was higher than that of the control group(P<0.05).The incidence of adverse reactions in the observation group was 7.32%,which was lower than 17.07%in the control group(P<0.05).Conclusion Dexmedetomidine combined with low-dose midazolam has a good sedative effect on slow induction of tracheal intubation,which can reduce the stress response of patients to tracheal intubation,promote postoperative recovery,reduce sedation score,achieve better sedation effect,reduce the impact on vital signs,avoid cognitive impairment,and have relatively better tolerance and safety..
作者
尚丹
张紫娟
SHANG Dan;ZHANG Zi-juan(Department of Anesthesiology,Fengcheng People’s Hospital,Fengcheng 331100,Jiangxi,China)
出处
《医学信息》
2022年第18期83-86,共4页
Journal of Medical Information
