中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2015年
9期
1000-1002
,共3页
右美托咪啶%咪达唑仑%颈椎%骨折%插管法,气管内
右美託咪啶%咪達唑崙%頸椎%骨摺%插管法,氣管內
우미탁미정%미체서륜%경추%골절%삽관법,기관내
Dexmedetomidine%Midazolam%Cervical vertebrae%Fractures%Intubation,intratracheal
目的 比较右旋美托咪啶与咪达唑仑对老年高位颈椎骨折清醒患者气管插管中镇静作用. 方法 选择我院2010年1月至2015年1月收治的老年高位颈椎骨折择期行清醒气管插管全麻手术治疗的68例患者为研究对象.随机分为右旋美托咪啶组和咪达唑仑组,其中右旋美托咪啶组34例,采用右旋美托咪啶麻醉诱导;咪达唑仑组34例,采用咪达唑仑麻醉诱导;对比分析两组患者入室后麻醉前(T1)、气管插管前即刻(T2)和插管后即刻(T3)患者心率、平均动脉压和脑电双频谱指数值(BIS)值,插管前后二氧化碳分压(PaCO2)值以及不良反应发生情况. 结果 T1时刻两组患者心率、平均动脉压和BIS比较差异无统计学意义(P＞0.05).T2和T3时刻右旋美托咪啶组患者心率、平均动脉压和BIS均明显低于咪达唑仑组(P＜0.010).气管插管前后两组患者组内和组间PaCO2值比较差异无统计学意义(P＞0.05),两组不良反应发生率比较差异无统计学意义(x2=1.308,P=0.253). 结论 与咪达唑仑比较右旋美托咪啶用于高位颈椎骨折患者清醒气管插管可更好稳定患者心率、平均动脉压和BIS,安全性好,值得临床应用.
目的 比較右鏇美託咪啶與咪達唑崙對老年高位頸椎骨摺清醒患者氣管插管中鎮靜作用. 方法 選擇我院2010年1月至2015年1月收治的老年高位頸椎骨摺擇期行清醒氣管插管全痳手術治療的68例患者為研究對象.隨機分為右鏇美託咪啶組和咪達唑崙組,其中右鏇美託咪啶組34例,採用右鏇美託咪啶痳醉誘導;咪達唑崙組34例,採用咪達唑崙痳醉誘導;對比分析兩組患者入室後痳醉前(T1)、氣管插管前即刻(T2)和插管後即刻(T3)患者心率、平均動脈壓和腦電雙頻譜指數值(BIS)值,插管前後二氧化碳分壓(PaCO2)值以及不良反應髮生情況. 結果 T1時刻兩組患者心率、平均動脈壓和BIS比較差異無統計學意義(P＞0.05).T2和T3時刻右鏇美託咪啶組患者心率、平均動脈壓和BIS均明顯低于咪達唑崙組(P＜0.010).氣管插管前後兩組患者組內和組間PaCO2值比較差異無統計學意義(P＞0.05),兩組不良反應髮生率比較差異無統計學意義(x2=1.308,P=0.253). 結論 與咪達唑崙比較右鏇美託咪啶用于高位頸椎骨摺患者清醒氣管插管可更好穩定患者心率、平均動脈壓和BIS,安全性好,值得臨床應用.
목적 비교우선미탁미정여미체서륜대노년고위경추골절청성환자기관삽관중진정작용. 방법 선택아원2010년1월지2015년1월수치적노년고위경추골절택기행청성기관삽관전마수술치료적68례환자위연구대상.수궤분위우선미탁미정조화미체서륜조,기중우선미탁미정조34례,채용우선미탁미정마취유도;미체서륜조34례,채용미체서륜마취유도;대비분석량조환자입실후마취전(T1)、기관삽관전즉각(T2)화삽관후즉각(T3)환자심솔、평균동맥압화뇌전쌍빈보지수치(BIS)치,삽관전후이양화탄분압(PaCO2)치이급불량반응발생정황. 결과 T1시각량조환자심솔、평균동맥압화BIS비교차이무통계학의의(P＞0.05).T2화T3시각우선미탁미정조환자심솔、평균동맥압화BIS균명현저우미체서륜조(P＜0.010).기관삽관전후량조환자조내화조간PaCO2치비교차이무통계학의의(P＞0.05),량조불량반응발생솔비교차이무통계학의의(x2=1.308,P=0.253). 결론 여미체서륜비교우선미탁미정용우고위경추골절환자청성기관삽관가경호은정환자심솔、평균동맥압화BIS,안전성호,치득림상응용.
Objective To compare the effects of Dexmedetomidine and Midazolam for sedation in elderly patient with upper cervical spine fracture in awake tracheal intubation.Methods A total of 68 patients with upper cervical spine fracture undergoing awake tracheal intubation who treated in our hospital from Jan.2010 to Jan.2015 were considered as the objects,who was randomly divided into group A and group B.34 cases in group A were treated with Dexmedetomidine for sedation,and the other 34 cases in group B were treated with Midazolam for sedation.The Heart rate (HR),mean arterial pressure (MAP) and BIS value on the before anesthesia (T1),immediately before intubation (T2),immediately after intubation (T3),PaCO2 in before and after intubation,and the adverse reactions were compared between the two groups.Results There was no difference in HR,MAP and BIS at time of T1 between the two groups (P＞0.05).The HR,MAP and BIS were lower in group A than in group B at time of T2 and T3 (P＜0.01).The PaCO2 had no difference between the two groups at before and after intubation (P＞ 0.05).The rate of adverse effects had no difference between the two groups (x2 =1.308,P =0.253).Conclusions Compared with Midazolam,Dexmedetomidine can stable HR,MAP and BIS effectively and has a good safety in the treatment of elderly upper cervical spine fracture in awake tracheal intubation,which is worthy of clinical application.
