咪达唑仑复合瑞芬太尼运用于脊椎骨折手术麻醉中的意义分析
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摘要
目的:研究咪达唑仑复合瑞芬太尼运用于脊椎骨折手术麻醉中的意义。方法:选取2017年3月—2018年2月在我院进行脊椎手术治疗的110例患者,按随机数字表法分为研究组与常规组,各55例。研究组采用咪达唑仑复合瑞芬太尼进行麻醉,常规组采用瑞芬太尼复合丙泊酚进行麻醉,比较两组麻醉后机能恢复情况及疼痛程度,麻醉前后呼吸、心率等生命体征水平,以及麻醉效果。结果 :研究组麻醉后呼吸恢复、睁眼、拔管及定向力恢复时间显著优于常规组,差异有统计学意义(P <0.05);研究组术后VAS评分优于常规组,差异有统计学意义(P <0.05);麻醉后研究组呼吸、心率及血氧饱和度与麻醉前比较差异无统计学意义(P> 0.05),但优于常规组,差异有统计学意义(P <0.05);研究组麻醉优良率为98.18%,显著高于常规组的69.09%,差异有统计学意义(P <0.05)。结论 :在脊椎骨折患者手术时采用咪达唑仑复合瑞芬太尼进行麻醉的效果理想,麻醉前后患者呼吸、心率等生命体征较稳定,且麻醉后患者机能恢复速度较快,对提高生活质量具有一定益处,值得推广。
Objective: To study the significance of midazolam combined with remifentanil used in anesthesia for spinal fracture surgery. Methods: 110 patients who underwent spinal surgery in our hospital from March 2017 to February 2018 were selected and randomly divided into a study group and a conventional group, 55 cases each. The patients in the study group were anaesthetized with midazolam and remifentanil, and the patients in the conventional group were anaesthetized with remifentanil and propofol. The functional recovery and pain degree after anesthesia, respiration, heart rate and other vital signs before and after anesthesia, and anesthetic effect were compared between the two groups. Results: The respiratory recovery, eye opening, extubation and orientation recovery time after anesthesia in the study group were significantly better than those in the conventional group, and the differences were statistically significant(P<0.05). The VAS scores in the study group were better than those in the conventional group, and the difference was statistically significant(P<0.05). There were no significant differences in respiration, heart rate and oxygen saturation in the study group between before and after treatment(P>0.05), but they were better than those in the conventional group, with statistically significant differences(P<0.05). The excellent and good rate of anesthesia in the study group was 98.18%, which was significantly higher than 69.09% in the conventional group, and the difference was statistically significant(P<0.05). Conclusion: Midazolam combined with remifentanil is ideal in anesthesia for the patients with spinal fractures, beneficial to the improvement of the quality of life and worth popularizing. The vital signs such as respiration and heart rate are stable before and after anesthesia, and the recovery of patients' functions is faster after anesthesia.
Objective: To study the significance of midazolam combined with remifentanil used in anesthesia for spinal fracture surgery. Methods: 110 patients who underwent spinal surgery in our hospital from March 2017 to February 2018 were selected and randomly divided into a study group and a conventional group, 55 cases each. The patients in the study group were anaesthetized with midazolam and remifentanil, and the patients in the conventional group were anaesthetized with remifentanil and propofol. The functional recovery and pain degree after anesthesia, respiration, heart rate and other vital signs before and after anesthesia, and anesthetic effect were compared between the two groups. Results: The respiratory recovery, eye opening, extubation and orientation recovery time after anesthesia in the study group were significantly better than those in the conventional group, and the differences were statistically significant(P<0.05). The VAS scores in the study group were better than those in the conventional group, and the difference was statistically significant(P<0.05). There were no significant differences in respiration, heart rate and oxygen saturation in the study group between before and after treatment(P>0.05), but they were better than those in the conventional group, with statistically significant differences(P<0.05). The excellent and good rate of anesthesia in the study group was 98.18%, which was significantly higher than 69.09% in the conventional group, and the difference was statistically significant(P<0.05). Conclusion: Midazolam combined with remifentanil is ideal in anesthesia for the patients with spinal fractures, beneficial to the improvement of the quality of life and worth popularizing. The vital signs such as respiration and heart rate are stable before and after anesthesia, and the recovery of patients' functions is faster after anesthesia.
引文
[1]李圣君,唐生富,李永霞.瑞芬太尼复合异丙酚在脊柱结核手术患者麻醉苏醒期的效果[J].海南医学,2017,28(23):3867-3869.
[2]徐茜,胡佳,李有长.丙泊酚、瑞芬太尼复合小剂量咪达唑仑全身麻醉用于妇科腹腔镜手术的效果研究[J].重庆医学,2017,46(A02):34-36.
[3]赵方,银瑞.依托咪酯复合瑞芬太尼对新生儿先天性肛门闭锁手术麻醉的影响[J].现代药物与临床,2018,33(2):399-402.
[4]孙茫,刘阳,于晴,等.瑞芬太尼或舒芬太尼复合丙泊酚在患儿纤维支气管镜检查中的应用[J].临床麻醉学杂志,2016,32(10):949-952.
[5]曹云.瑞芬太尼全麻在经皮肾镜碎石手术麻醉中的应用价值[J].昆明医科大学学报,2016,37(1):133-136.
[6]王雷,袁利刚,董擂.瑞芬太尼联合咪达唑仑用于内镜逆行性胆管造影监护性麻醉的效果分析[J].中国普通外科杂志,2016,25(10):1517-1521.
[7]宋华勇,张涛,张光信,等.瑞芬太尼与丙泊酚混合溶液自控镇痛镇静在老年患者肠镜检查中的应用[J].华西医学,2016,31(10):1682-1685.
[8]蔡小芳,张芙蓉,张隆,等.镇痛镇静策略在PICU机械通气患儿中的应用[J].中国当代儿科杂志,2017,19(11):1138-1144.
[9]高晓增,闫晓燕,刘铁军,等.七氟醚复合麻醉与异丙酚复合麻醉下妇科腹腔镜手术患者脑氧饱和度的比较[J].中华麻醉学杂志,2016,36(1):71-74.
[10]王红运,高臻辉,薛晓玲.麻醉诱导前给予咪达唑仑在甲状腺癌根治术中的麻醉效果及对苏醒质量的影响[J].解放军医药杂志,2017,29(5):101-104
[11]彭丹丹,王敏.地佐辛联合瑞芬太尼用于阿尔茨海默病患者白内障超声乳化摘除术镇静镇痛的疗效观察[J].蚌埠医学院学报,2016,41(1):59-62.
[12]Eshghi A,Mohammadpour M,Kaviani N,et al.Comparative evaluation of bispectral index system after sedation with midazolam and propofol combined with remifentanil versus ketamine in uncooperative during dental procedures[J].Dent Res J(Isfahan),2016,13(1):1-6.
[2]徐茜,胡佳,李有长.丙泊酚、瑞芬太尼复合小剂量咪达唑仑全身麻醉用于妇科腹腔镜手术的效果研究[J].重庆医学,2017,46(A02):34-36.
[3]赵方,银瑞.依托咪酯复合瑞芬太尼对新生儿先天性肛门闭锁手术麻醉的影响[J].现代药物与临床,2018,33(2):399-402.
[4]孙茫,刘阳,于晴,等.瑞芬太尼或舒芬太尼复合丙泊酚在患儿纤维支气管镜检查中的应用[J].临床麻醉学杂志,2016,32(10):949-952.
[5]曹云.瑞芬太尼全麻在经皮肾镜碎石手术麻醉中的应用价值[J].昆明医科大学学报,2016,37(1):133-136.
[6]王雷,袁利刚,董擂.瑞芬太尼联合咪达唑仑用于内镜逆行性胆管造影监护性麻醉的效果分析[J].中国普通外科杂志,2016,25(10):1517-1521.
[7]宋华勇,张涛,张光信,等.瑞芬太尼与丙泊酚混合溶液自控镇痛镇静在老年患者肠镜检查中的应用[J].华西医学,2016,31(10):1682-1685.
[8]蔡小芳,张芙蓉,张隆,等.镇痛镇静策略在PICU机械通气患儿中的应用[J].中国当代儿科杂志,2017,19(11):1138-1144.
[9]高晓增,闫晓燕,刘铁军,等.七氟醚复合麻醉与异丙酚复合麻醉下妇科腹腔镜手术患者脑氧饱和度的比较[J].中华麻醉学杂志,2016,36(1):71-74.
[10]王红运,高臻辉,薛晓玲.麻醉诱导前给予咪达唑仑在甲状腺癌根治术中的麻醉效果及对苏醒质量的影响[J].解放军医药杂志,2017,29(5):101-104
[11]彭丹丹,王敏.地佐辛联合瑞芬太尼用于阿尔茨海默病患者白内障超声乳化摘除术镇静镇痛的疗效观察[J].蚌埠医学院学报,2016,41(1):59-62.
[12]Eshghi A,Mohammadpour M,Kaviani N,et al.Comparative evaluation of bispectral index system after sedation with midazolam and propofol combined with remifentanil versus ketamine in uncooperative during dental procedures[J].Dent Res J(Isfahan),2016,13(1):1-6.