右美托咪定超前镇痛对重度烧伤患者血清炎性因子及血流动力学的影响

Effect of Dexmedetomidine Preemptive Analgesia on Serum Inflammatory Factors and Hemodynamics in Severely Burned Patients

目的分析右美托咪定超前镇痛在重度烧伤患者中的应用效果。方法选取86例重度烧伤患者,按随机数字表法分为两组,各43例。观察组于麻醉前10min注入1μg/kg右美托咪定,之后以0.5μg/(kg·h)的速率泵注,术毕前30min停药,对照组以相同方式注入等量的生理盐水。对比两组镇静镇痛效果、血清炎性因子水平、血流动力学。结果观察组镇痛起效时间为(2.06±0.41)min,短于对照组的(4.89±0.95)min,镇痛持续时间为(123.48±10.67)min,长于对照组的(95.31±8.46)min,差异有统计学意义(P<0.05);麻醉前(T0),两组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、心率(HR)、平均动脉压(MAP)相比,差异无统计学意义(P>0.05);手术开始后30min(T_(1))、术毕时(T_(2)),观察组CRP、TNF-α、IL-6、HR、MAP低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定在重度烧伤患者中可发挥超前镇痛效果,减轻机体炎性反应,稳定患者血流动力学,临床应用价值较高,可进行大力的推行与运用。

Objective To analyze the application effect of dexmedetomidine preemptive analgesia in severe burn patients.Methods 86 severe burn patients diagnosed and treated were selected and randomly divided into two groups,with 43 patients in each group.Observation group injected 10 minutes before anesthesia 1μg/kg dexmedetomidine,followed by 0.5μg Pump at a rate of 1g/(kg·h),discontinue medication 30 minutes before surgery,and inject the same amount of physiological saline into the control group in the same manner.Compare the sedative and analgesic effects,serum inflammatory factor levels,and hemodynamics between the two groups.Results The analgesic onset time of the observation group was(2.06±0.41)minutes,shorter than the control group's(4.89±0.95)minutes,the analgesic duration was(123.48±10.67)minutes,and longer than the control group's(95.31±8.46)minutes,with a statistical difference(P<0.05);Before anesthesia(T0),two groups of C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)、There was no statistically significant difference in levels of interleukin-6(IL-6),heart rate(HR),and mean arterial pressure(MAP)(P>0.05);30 minutes after the start of surgery(T_(1))and at the end of surgery(T_(2)),the observation group showed CRP and TNF-α、IL-6,HR,and MAP were lower than the control group,with statistical differences(P<0.05).Conclusion Dexmetomidine can exert preemptive analgesic effects in severe burn patients,reduce inflammatory reactions,stabilize patient hemodynamics,and has high clinical application value.It can be vigorously promoted and applied.