| 王景坤,钟福如,何晓霞.氟比洛芬酯联合舒芬太尼及右美托咪定对全麻重度烧伤切痂植皮手术患者苏醒期躁动的影响.[J].中南医学科学杂志.,2022,(1):132-136. |
| 氟比洛芬酯联合舒芬太尼及右美托咪定对全麻重度烧伤切痂植皮手术患者苏醒期躁动的影响 |
| Effects of flurbiprofen axetil combined with sufentanil and dexmedetomidine on emergence agitation in patients with severe burns undergoing escharectomy and skin grafting under general anesthesia |
| 投稿时间：2021-03-06 修订日期：2021-06-03 |
| DOI：10.15972/j.cnki.43-1509/r.2022.01.032 |
| 中文关键词: 重度烧伤切痂植皮术 全身麻醉 苏醒期躁动 氟比洛芬酯 舒芬太尼 右美托咪定 |
| 英文关键词:escharectomy and skin grafting of severe burns general anesthesia emergence agitation flurbiprofen axetil sufentanil dexmedetomidine |
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| 中文摘要: |
| 目的观察氟比洛芬酯联合舒芬太尼、右美托咪定麻醉镇痛在全麻下切痂植皮手术者中应用价值。方法88例重度烧伤行全麻下切痂植皮术者随机分为观察组、对照组各44例,对照组手术结束前30 min静脉注射舒芬太尼(0.1 μg/kg)、右美托咪定(0.25 μg/kg),观察组在对照组基础上静脉注射氟比洛芬酯50 mg。记录两组术后自主呼吸恢复、唤醒、拔管、定向力恢复时间。比较两组麻醉诱导前(T0)、手术结束时(T1)、拔管前(T2)、拔管后即刻(T3)、拔管后15 min(T4)时心率(HR)、平均动脉压(MAP)；T0、T4时血浆皮质醇(COR)、肾上腺素(E)、去甲肾上腺素(NE)；T4时镇静(Ramsay镇静评分)、镇痛[视觉模拟评分(VAS)]、躁动分级,统计躁动、药物不良反应发生率。结果两组术后自主呼吸恢复、唤醒、拔管、定向力恢复时间比较均无统计学意义(P＞0.05)。T1~T4时,观察组HR、MAP均低于对照组同时间点(P＜0.05)。T4时,观察组血浆COR、E、NE均低于对照组(P＜0.05),VAS评分低于对照组(P＜0.05)。观察组躁动发生率为6.82%,低于对照组的25.00%(P＜0.05)；两组药物不良反应发生率无统计学意义(P＞0.05)。结论氟比洛芬酯联合舒芬太尼、右美托咪定用于重度烧伤行全麻下切痂植皮手术者,可减轻患者术后血流动力学波动、应激反应、疼痛及苏醒期躁动,且安全性好。 |
| 英文摘要: |
| To observe the application value of flurbiprofen axetil combined with sufentanil and dexmedetomidine for anesthesia and analgesia in patients undergoing escharectomy and and skin grafting under general anesthesia.Methods88 patients with severe burns undergoing escharectomy and skin grafting under general anesthesia were divided into observation group and control group according to the random envelope method, with 44 cases in each group. Control group was intravenously injected with sufentanil at 0.1 μg/kg and dexmedetomidine at 0.25 μg/kg respectively at 30min before the end of surgery, and observation group was given intravenous injection of 50mg flurbiprofen axetil on the basis of control group. The recovery time of postoperative spontaneous breathing, wake-up time, extubation time and orientation recovery time were recorded in the two groups. The heart rate (HR) and mean arterial pressure (MAP) before anesthesia induction (T0), at the end of the surgery (T1), before extubation (T2), immediately after extubation (T3) and at 15min after extubation (T4), plasma cortisol (COR), epinephrine (E) and norepinephrine (NE) at T0 and T4, sedation (Ramsay sedation score), analgesia [Visual Analogue Score (VAS)] and agitation grading at T4 were compared between the two groups, and the incidence rates of agitation and drug side effects were statistically analyzed. ResultsThere were no statistically significant differences in recovery time of postoperative spontaneous breathing, wake-up time, extubation time and orientation recovery time between the two groups (P＞0.05). The HR and MAP in observation group from T1 to T4 were significantly lower than those in control group at the same time point (P＜0.05). At T4, the levels of plasma COR, E and NE in observation group were significantly lower than those in control group (P＜0.05), and the VAS score was significantly lower than that in control group (P＜0.05). The incidence rate of agitation in observation group was significantly lower than that in control group (6.82% vs 25.00%) (P＜0.05). There was no significance in the incidence of drug side effects between the two groups (P＞0.05). ConclusionFlurbiprofen axetil combined with sufentanil and dexmedetomidine for patients with severe burns undergoing escharectomy and skin grafting under general anesthesia can relieve the postoperative hemodynamic fluctuations, stress response, pain level and emergence agitation, with good safety. |
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