右美托咪定治疗急诊脑外伤气管插管患者的效果及安全性分析

Efficacy and safety of dexmedetomidine in the treatment of emergency patients with traumatic brain injury and tracheal intubation

目的探讨右美托咪定治疗急诊脑外伤气管插管患者的效果及安全性。方法抽取2018年9月~2020年8月时间段急诊科收治的60例需要行气管插管的脑外伤患者为对象进行研究,根据其入院ID号将其分成两组实施研究,其中对照组30例给予咪达唑仑实施麻醉,观察组30例给予右美托咪定实施麻醉,对比两组患者不同时间点的血流动力学变化情况、插管成功率、麻醉指标及药物的安全性研究结果。结果观察组气管插管成功率96.67%(29/30),对照组气管插管成功率93.33%(28/30),组间对比差异无统计学意义(P>0.05);两组患者T0时间段心率及血压水平差异无统计学意义(P>0.05),T1及T2时间段观察组心率及血压水平均低于对照组,且观察组血流动力学指标波动幅度较对照组小(P<0.05);与对照组比较,观察组镇静起效时间更快,麻醉苏醒时间更短,唤醒睁眼时间更短及定向力恢复时间更短(P<0.05);观察组3例(10.00%)出现不良反应,对照组10例(33.33%)出现不良反应,两组差异有统计学意义(P<0.05)。结论针对需要行气管插管的急诊脑外伤患者,采用右美托咪定麻醉可减轻患者气管插管时的心血管反应,对其呼吸功能产生的影响较小,且能快速起到镇静效果,促使患者尽早苏醒。

Objective To investigate the efficacy and safety of dexmedetomidine in the treatment of emergency patients with traumatic brain injury and tracheal intubation.Methods 60 patients with traumatic brain injury who need endotracheal intubation in the emergency department from September 2018 to August 2020 were selected and divided into two groups according to their admission ID number.Among them,30 patients in the control group were given midazolam anesthesia,and 30 patients in the observation group were given dexmedetomidine for anesthesia at the same time point,hemodynamic changes,intubation success rate,anesthesia indicators and drug safety were compared.Results The success rate of endotracheal intubation in the observation group was 96.67%(29/30)and that in the control group was 93.33%(28/30),with no significant difference between the two groups(P>0.05).There was no significant difference in heart rate and blood pressure between the two groups at T0(P>0.05).The heart rate and blood pressure levels in the observation group were lower than those in the control group at T1 and T2,and the fluctuation range of hemodynamic indexes in the observation group was smaller than that in the control group(P<0.05);compared with the control group,the sedation onset time of the observation group was faster,the anesthesia recovery time was shorter,the wakeup time was shorter,and the recovery time of directional force was shorter(P<0.05);3 cases(10.00%)in the observation group had adverse reactions and 10 cases(33.33%)in the control group had adverse reactions.The difference between the two groups was significant(P<0.05).Conclusion Dexmedetomidine anesthesia can reduce the cardiovascular reaction of patients with endotracheal intubation in emergency brain trauma patients who need tracheal intubation,and has little impact on their respiratory function.It can quickly play a sedative effect and promote patients to wake up as soon as possible.