右美托咪定复合异丙酚和瑞芬太尼在重度烧伤患者围术期麻醉中的临床效果

Clinical Effect of Dexmedetomidine Combined with Propofol and Remifentanil in Perioperative Anesthesia for Severe Burn Patients

目的:分析右美托咪定、异丙酚、瑞芬太尼用于重度烧伤患者围术期的麻醉效果。方法:选择我院2018年11月-2019年11月收治的58例重度烧伤患者,均行手术治疗,给予右美托咪定麻醉的29例为单一组,另外29例作为综合组,以右美托咪定、异丙酚、瑞芬太尼麻醉,观察2组血流动力学指标及炎性指标。结果:综合组麻醉前的平均动脉压为(88.13±6.29)mmHg、心率为(94.27±6.83)次/min,与手术中、拔管时相比无差异,P>0.05。单一组麻醉前平均动脉压(88.25±6.41)mmHg,低于手术中,心率(93.22±6.13)次/min,低于手术中与拔管时,P<0.05。综合组IL-6(45.17±6.28)pg/ml、IL-10(33.41±6.58)pg/ml、TNF-α(47.19±7.32)pg/ml,低于单一组,P<0.05。结论:右美托咪定、异丙酚、瑞芬太尼用于重度烧伤患者围术期,可让患者血流动力学保持在稳定状态,且炎性反应有所减轻,效果显著。

Objective:To analyze the perioperative anesthetic effects of dexmedetomidine,propofol and remifentanil in patients with severe bums.Methods:58 patients with severe bums admitted to our hospital from November 2018 to November 2019 were selected for surgical treatment.29 patients were given dexmedetomidine anesthesia as a single group,and the other 29 patients in the sitting comprehensive group were given dexmedetomidine,propofol and remifentanil anesthesia.The hemodynamic indexes and inflammatory indexes of the two groups were observed.Results:The average arterial pressure and heart rate before anesthesia in the comprehensive group were(88.136.29)and(94.276.83)respectively,which were not different from those during surgery and extubation(P>0.05).Before anesthesia,the average arterial pressure(88.256.41)in the single group was lower than that in the operation,and the heart rate(93.226.13)was lower than that in the operation and extubation,P&lt;0.05.The levels of il-6(45.176.28),il-IL-10(33.41±6.58)and TNF-α.(47.197.32)in the comprehensive group were lower than those in the single group,P&lt;0.05.Conclusion:Dexmedetomidine,propofol and remifentanil can keep the hemodynamics in a stable state during the perioperative period for patients with severe bums,and the inflammatory reaction is alleviated with significant effect.