体外循环术后盐酸右美托咪啶联合咪唑安定镇静的临床观察
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摘要
目的探讨体外循环术后盐酸右美托咪啶联合咪唑安定的镇静效果。方法选取2015年10月—2016年10月因先天性心脏病行体外循环术的患儿120例,随机分为右美托咪啶组、咪唑安定组、联合用药组,每组40例。比较3组患儿的桡动脉平均动脉压(Mean Artery Pressure,MAP)、心率(Heart Rate,HR)、药物起效时间、苏醒时间、Ramsay评分。结果联合用药组患儿的药物起效时间明显短于右美托咪啶组及咪唑安定组(均P<0.01),3组患儿的苏醒时间无统计学差异(P>0.05)。联合用药组患儿的MAP、HR均低于同期对照组(均P<0.01)。联合用药组患儿术中和术后的Ramsay评分显著优于右美托咪啶组及咪唑安定组(均P<0.05)。结论盐酸右美托咪定联合咪唑安定的镇静效果优于单独使用咪唑安定及右美托咪啶,对减少手术时间、维持患儿血流动力学稳定有积极意义。
Objective To discuss the sedative effect of dexmedetomidine hydrochloride combined with midazolam on patients after cardiopulmonary bypass surgery. Methods 120 children with congenital heart disease who underwent cardiopulmonary bypass from Oct. 2015 to Oct. 2016 were chosen and randomly divided into dexmedetomidine group,midazolam group and combination group,40 cases in each. The mean arterial pressure( MAP) of radial artery,heart rate( HR),drug onset time,recovery time and Ramsay score of the children were compared between the 3 groups. Results The onset time of the drug in the combination group was significantly shorter than that in the dexmedetomidine group and the midazolam group( P < 0. 01). There was no significant difference of the recovery time among the three groups( P > 0. 05). The MAP and HR of the patients in the combination group were lower than those in the control groups( P < 0. 01). The Ramsay score of the combination group was significantly higher than that of the dexmedetomidine group and the midazolam group( P < 0. 05).Conclusion The sedative effect of dexmedetomidine hydrochloride combined with midazolam hydrochloride is better than that of imidazolam or dexmedetomidine alone,which has a positive significance to reduce the operation time and maintain the hemodynamic stability of children patients.
Objective To discuss the sedative effect of dexmedetomidine hydrochloride combined with midazolam on patients after cardiopulmonary bypass surgery. Methods 120 children with congenital heart disease who underwent cardiopulmonary bypass from Oct. 2015 to Oct. 2016 were chosen and randomly divided into dexmedetomidine group,midazolam group and combination group,40 cases in each. The mean arterial pressure( MAP) of radial artery,heart rate( HR),drug onset time,recovery time and Ramsay score of the children were compared between the 3 groups. Results The onset time of the drug in the combination group was significantly shorter than that in the dexmedetomidine group and the midazolam group( P < 0. 01). There was no significant difference of the recovery time among the three groups( P > 0. 05). The MAP and HR of the patients in the combination group were lower than those in the control groups( P < 0. 01). The Ramsay score of the combination group was significantly higher than that of the dexmedetomidine group and the midazolam group( P < 0. 05).Conclusion The sedative effect of dexmedetomidine hydrochloride combined with midazolam hydrochloride is better than that of imidazolam or dexmedetomidine alone,which has a positive significance to reduce the operation time and maintain the hemodynamic stability of children patients.
引文
[1]汪灵芝,廖敏,赖永东,等.不同剂量右美托咪定应用于剖宫产术中预防卡前列素氨丁三醇不良反应的对比研究[J].现代医院,2015,15(7):18-20.
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[9]周东旭,徐波,关婷,等.丙泊酚诱导下右美托咪定抑制女性患者喉罩置入心血管反应的半数有效剂量[J].实用医学杂志,2016,32(3):463-466.
[10]黎耀辉,程平瑞.不同剂量右美托咪定对腰硬联合麻醉下经皮肾镜碎石术患者的镇静效应和安全性研究[J].广州医药,2017,48(1):76-80.
[11]杨柳,姚少红,潘秋宁,等.右美托咪定复合地佐辛对关节置换术患者镇痛效果及对儿茶酚胺、内皮素-1的影响[J].中国医药科学,2016,6(11):156-159.
[12]吴春艳.右美托咪定和咪唑安定对ICU机械通气病人镇静作用的临床观察[J].中国冶金工业医学杂志,2016,33(1):24-25.
[13]王冠军.咪唑安定辅助区域麻醉合适镇静深度及用量的研究[J].医学理论与实践,2015,28(9):1139-1140.
[14]周结贤,龙丽,林萍.探讨咪唑安定与异丙酚复合诱导在妇科肿瘤患者麻醉中的临床应用效果[J].海峡药学,2016,28(4):170-171.
[15]姚倚.咪唑安定联合丙泊酚在妇科手术镇静中的应用及护理[J].中国药业,2011,20(3):66-67.
[16]荣燕,王晓琳,郁娜,等.咪唑安定联合异丙酚在老年人单侧下肢手术联合镇静麻醉效果[J].中外医疗,2016,35(27):121-122.
[2]程照丽,陈永莉,杨凤梅,等.Ramsay评分在ICU机械通气患者镇静护理中的应用探讨[J].中国现代医药杂志,2015(11):80-82.
[3]任珂.盐酸右美托咪定用于重症监护患者镇静及镇痛的临床观察[J].中国实用医药,2015(4):166-167.
[4]赵娟,郑丽宏.右美托咪定在临床麻醉中的作用优势[J].实用医学杂志,2015,31(8):1355-1357.
[5]李远华,戚应静,吴苏华,等.右美托咪啶在慢性阻塞性肺疾病急性加重期患者脱机后镇静作用临床研究[J].国际医药卫生导报,2015,21(15):2233-2235.
[6]卢彬,余璇,周易,等.盐酸右美托咪定与丙泊酚、咪唑安定以及杜氟合剂镇静效果的比较[J].实用医院临床杂志,2014,11(6):55-57.
[7]储浩,张野,王胜斌.不同剂量右美托咪啶联合罗哌卡因髂筋膜间隙阻滞在全髋关节置换术中的应用[J].实用医学杂志,2017,33(10):1673-1677.
[8]梁飞,肖晓山,李俊,等.盐酸右美托咪定在臂丛神经阻滞中的作用[J].广东医学,2011,32(17):2273-2275.
[9]周东旭,徐波,关婷,等.丙泊酚诱导下右美托咪定抑制女性患者喉罩置入心血管反应的半数有效剂量[J].实用医学杂志,2016,32(3):463-466.
[10]黎耀辉,程平瑞.不同剂量右美托咪定对腰硬联合麻醉下经皮肾镜碎石术患者的镇静效应和安全性研究[J].广州医药,2017,48(1):76-80.
[11]杨柳,姚少红,潘秋宁,等.右美托咪定复合地佐辛对关节置换术患者镇痛效果及对儿茶酚胺、内皮素-1的影响[J].中国医药科学,2016,6(11):156-159.
[12]吴春艳.右美托咪定和咪唑安定对ICU机械通气病人镇静作用的临床观察[J].中国冶金工业医学杂志,2016,33(1):24-25.
[13]王冠军.咪唑安定辅助区域麻醉合适镇静深度及用量的研究[J].医学理论与实践,2015,28(9):1139-1140.
[14]周结贤,龙丽,林萍.探讨咪唑安定与异丙酚复合诱导在妇科肿瘤患者麻醉中的临床应用效果[J].海峡药学,2016,28(4):170-171.
[15]姚倚.咪唑安定联合丙泊酚在妇科手术镇静中的应用及护理[J].中国药业,2011,20(3):66-67.
[16]荣燕,王晓琳,郁娜,等.咪唑安定联合异丙酚在老年人单侧下肢手术联合镇静麻醉效果[J].中外医疗,2016,35(27):121-122.