对比右美托咪定与咪达唑仑用于区域麻醉骨科手术镇静的临床价值

Clinical Value of Dexmedetomidine and Midazolam for Sedation in Orthopedic Surgery under Regional Anesthesia

目的探讨分别采用右美托咪定以及咪达唑仑展开区域麻醉骨科手术患者的镇静干预后获得的临床效果。方法选取2020年2月—2023年5月通用环球中铁邳州医院收治的90例区域麻醉骨科手术患者为研究对象,以投掷硬币法分为参照组(45例,在手术镇静中应用咪达唑仑)和研究组(45例,在手术镇静中应用右美托咪定)。比较两组不同时间点的警觉/镇静评分、不良反应发生率。结果两组不同时间点的警觉/镇静评分比较,差异无统计学意义(P均>0.05)。与参照组呼吸抑制发生率(13.33%)以及心动过缓发生率(17.78%)比较,研究组患者的呼吸抑制发生率(0)以及心动过缓发生率(2.22%)更低,差异有统计学意义(χ^(2)=4.464、4.444,P均<0.05)。结论右美托咪定以及咪达唑仑的合理运用,可将区域麻醉骨科手术患者的镇静效果显著提升,但对于呼吸抑制情况等,采用右美托咪定则可以较好避免,所以右美托咪定应用效果更优。

Objective To investigate the clinical effect of sedation intervention in patients undergoing orthopedic sur-gery under regional anesthesia with dexmedetomidine and midazolam respectively.Methods Ninety patients undergo-ing orthopedic surgery under regional anesthesia admitted to General Global China Railway Pizhou Hospital from Feb-ruary 2020 to May 2023 were selected as the study subjects.They were divided into reference group(45 cases,mid-azolam was selected for surgical sedation)and study group(45 cases,dexmedetomidine was selected for surgical seda-tion.)using the coin toss method.The Observer's Assessment of Alertness/Sedation scores at different time points and incidence of adverse reactions between two groups were compared.Results There were no statistically significant dif-ferences in Assessment of Alertness/Sedation scores between two groups at different time points(all P>0.05).Com-pared with the incidence of respiratory depression(13.33%)and bradycardia(17.78%)in the reference group,the inci-dence of respiratory depression(0)and bradycardia(2.22%)in the study group patients were lower,and the differ-ences were statistically significant(χ^(2)=4.464,4.444,both P<0.05).Conclusion The rational use of dexmedetomidine and midazolam can significantly improve the sedation effect of orthopedic surgery patients under regional anesthesia.However,for respiratory depression,the application of dexmedetomidine can be better avoided,so the application ef-fect of dexmedetomidine is better.