[1]张敬莹,尚 游,张心宇.不同吸入麻醉药物对四肢创伤性骨折患者苏醒期躁动的影响[J].陕西医学杂志,2021,50(2):162-165.[doi:DOI:10.3969/j.issn.1000-7377.2021.02.009]
　ZHANG Jingying,SHANG You,ZHANG Xinyu.Effects of different inhaled anesthetics on emergence agitation in patients with traumatic limb fractures[J].,2021,50(2):162-165.[doi:DOI:10.3969/j.issn.1000-7377.2021.02.009]
点击复制

不同吸入麻醉药物对四肢创伤性骨折患者苏醒期躁动的影响
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年2期
页码:
162-165
栏目:
临床研究
出版日期:
2021-02-05

文章信息/Info

Title:
Effects of different inhaled anesthetics on emergence agitation in patients with traumatic limb fractures
作者:
张敬莹; 尚 游; 张心宇
(锦州医科大学附属第一医院,辽宁 锦州121000)
Author(s):
ZHANG Jingying; SHANG You; ZHANG Xinyu
(The Frist Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China)
关键词:
骨折;  吸入麻醉;  七氟醚;  地氟醚;  苏醒期躁动
Keywords:
Fracture;  Inhalation anesthesia;  Sevoflurane;  Desflurane;  Emergence agitation
分类号:
R 658
DOI:
DOI:10.3969/j.issn.1000-7377.2021.02.009
文献标志码:
A
摘要:
目的:比较不同吸入麻醉药物对四肢创伤性骨折患者苏醒期躁动(EA)的影响,为骨科麻醉患者药物的选择提供参考。方法:选择四肢创伤性骨折需切开复位内固定患者102例作为研究对象,采用数字表随机法分为七氟醚组(S组)51例和地氟醚组(D组)51例,比较两组苏醒期躁动发生率、严重程度及麻醉相关不良事件发生情况。结果:D组苏醒时间为(15.84±2.98)min,S组为(19.71±3.75)min,D组苏醒时间短于S组,两组比较差异有统计学意义(P<0.05); 麻醉时间、手术时间、拔管时间和舒芬太尼总用量,两组比较差异均无统计学意义(均P>0.05); D组不良反应发生率为23.53%,苏醒躁动率为11.76%,高于S组的11.76%、1.96%,两组比较差异均有统计学意义(均P<0.05); D组拔管时、拔管后10 min Riker镇静躁动(SAS)评分低于S组,RS评分高于S组,两组比较差异均有统计学意义(均P<0.05)。结论:地氟醚吸入麻醉患者术后苏醒时间短于七氟醚吸入麻醉,但患者术后苏醒期躁动发生率及躁动程度均高于七氟醚吸入麻醉,提示使用地氟醚吸入麻醉要注意苏醒期躁动的防治。
Abstract:
Objective:To compare the effects of different inhaled anesthetics on emergence agitation(EA)in patients with traumatic fractures of the limbs,and to provide reference for the selection of drugs for orthopedic anesthesia patients.Methods:A total of 102 patients with traumatic limb fractures requiring open reduction and internal fixation were selected as the research objects.They were randomly divided into sevoflurane group(S group)and desflurane group(D group)with 51 cases in each.The incidence,severity of EA,and the occurrence of adverse events related to anesthesia in the two groups were compared.Results:The wake-up time of group D was(15.84±2.98)min,and the wake-up time of group S was(19.71±3.75)min.The wake-up time of group D was shorter than that of group S(P<0.05).Anesthesia time,operation time,extubation time and total dosage of sufentanil were not significantly different between the two groups(all P>0.05).The incidence of adverse reactions in group D was 23.53%,and the rate of EA was 11.76%,which was higher than those in group S(11.76% and 1.96%),the difference was statistically significant(all P<0.05).The Riker SAS score of group D was lower than that of group S at the time of extubation and 10 minutes after extubation,and the RS score was higher than that of group S(all P<0.05).Conclusion:The postoperative wake-up time of desflurane inhaled anesthesia patients is shorter than that of sevoflurane inhaled anesthesia,but the incidence and degree of EA during the postoperative wake-up period are higher than those of sevoflurane inhaled anesthesia.It is suggested that attention should be paid to the prevention and treatment of EA during the wake-up period when using desflurane inhalation anesthesia.

参考文献/References:

[1] 梁敏运,屠佳慧.右美托咪定对老年全身麻醉患者术后苏醒期躁动及术后认知功能的影响[J].中国老年学杂志,2018,38(14):3403-3405.
[2] 周俊辉,刘晓乐,孟宪慧,等.远隔缺血预处理对食管癌根治术老年患者全身麻醉苏醒期躁动及术后早期康复的改善作用[J].山东医药,2019,59(12):77-80.
[3] Ringblom J,Wgthlin I,Proczkowska M.A psychometric evaluation of the pediatric anesthesia emergence delirium scale[J].Paediatr Anaesth,2018,28(4):332-337.
[4] 刘金虎.老年患者全身麻醉术后苏醒期躁动的Logistic回归分析[J].中国实验诊断学,2016,20(12):2030-2033.
[5] 袁华平,刘艳军,陈 春,等.腹腔镜全子宫切除术中右美托咪定、帕瑞昔布钠联用对患者苏醒期躁动的预防效果[J].山东医药,2017,57(11):94-96.
[6] 王成钢,郭志佳.丙泊酚与七氟醚对颈椎手术患者术后恢复程度影响的研究[J].中国药物与临床,2018,18(11):2002-2003.
[7] Ge YL,Li X,Gao JU,et al.Beneficial effects of intravenous dexmedetomidine on cogmitive function and ceredral injury following a carotid endarterectomy[J].Exp Ther Med,2016,11(3):1128-1134.
[8] 刘莹瑞,段立波.地氟醚药理特性及其临床应用的研究进展[J].吉林大学学报:医学版,2018,44(2):448-454.
[9] 罗 艳,姚尚龙,杨拔贤,等.中国麻醉医师在全身麻醉中七氟醚使用习惯的多中心研究[J].临床麻醉学杂志,2016,32(1):6-9.
[10] Lim BG,Lee IO,Ahn H,et al.Comparison of the incidence of emergence agitation and emergence times between desflurane and sevoflurane anesthesia in children:A systematic review and meta-analysis[J].Medicine(Baltimore),2016,95(38):4927.
[11] He J,Zhang Y,Xue R,et al.Effect of desflurane versus sevoflurane in pediatric anesthesia:A meta-analysis[J].J Pharm Pharmaceut Set,2015,18(2):199-206.
[12] Dalal KS,Choudhary MV,Palsania AJ,et al.Desflurane for ambulatory anaesthesia:A comparison with sevoflurane for recovery profile and airway restonses[J].Indian J Anaesth,2017,61(4):315-320.
[13] Suzuki T,Kurazumi T,Ueda T,et al.Desflurane anesthesia worsens emergence agitation in adult patients undergoing thyroid surgery compared to sevoflurane anesthesia[J].JA Clin Rep,2017,3(1):36-41.
[14] Choi GJ,Back CW,Kang H,et al.Emergence agitation after or-thognathic surgery:A randomised controlled comparison between sevonurane and desflurane[J].Acta Anaesthesiol Scand,2015,59(2):224-231.

相似文献/References:

[1]黄小俊,佘刚,张文凯,等.加长PFNA-Ⅱ治疗老年股骨转子部粉碎性骨折疗效观察[J].陕西医学杂志,2016,(10):1331.
　Huang Xiaojun,She Gang,Zhang Wenkai,et al.[J].,2016,(2):1331.
[2]易智,刘时璋,史纪元,等.关节镜下爱惜邦缝线固定治疗胫骨髁间棘骨折16例[J].陕西医学杂志,2016,(10):1340.
[3]王化齐,曹善友,张光祥,等.解剖钢板内固定治疗老年肱骨外科颈粉碎性骨折48例分析[J].陕西医学杂志,2016,(09):1203.
[4]赵 斌,王文利,齐文胜,等.股骨近端锁定接骨板与股骨近端髓内钉治疗老年偏瘫患者 股骨转子间骨折疗效对比研究[J].陕西医学杂志,2019,(2):193.
　ZHAO Bin,WANG Wenli,QI Wensheng,et al.Treatment of proximal femoral locking plate and proximal femoral intramedullary nail PFNA Ⅱa comparative〖JP〗 〖JP3〗study on curative effect of intertrochanteric fracture of femur in elderly patients with hemiplegia[J].,2019,(2):193.
[5]张 建 ,宋 哲△ ,杨 娜 ,等.3D打印技术在复杂关节内骨折中的临床应用*[J].陕西医学杂志,2019,(3):322.
　ZHANG Jian,SONG Zhe,YANG Na,et al.Clinical application of 3D printing for the complex intraarticular fractures[J].,2019,(2):322.
[6]刘谦性,贺地震△,刘 勇.老年股骨颈骨折患者围术期下肢深静脉血栓形成情况及危险因素分析*[J].陕西医学杂志,2019,(10):1363.

更新日期/Last Update: 2021-01-28