右美托咪定复合瑞芬太尼在多发肋骨骨折患者术后康复期间的应用效果

Application Effect of Dexmedetomidine Combined with Remifentanil in Postoperative Rehabilitation of Patients with Multiple Rib Fractures

目的:分析右美托咪定复合瑞芬太尼在多发肋骨骨折患者术后康复期间的应用效果。方法:选取本院2021年1月—2023年1月接收的多发肋骨骨折术后患者86例,依据随机抽签法分为对照组和研究组,各43例。对照组接受瑞芬太尼持续静脉泵入干预,研究组基于对照组联合应用右美托咪定静脉泵入干预,比较两组用药前(T_(1))、用药5 min(T_(2))、用药30 min(T_(3))、用药1 h(T_(4))、用药3 h(T_(5))、用药12 h(T_(6))、用药1 d(T_(7))疼痛行为量表(BPS)、RASS评分、血流动力学[心率(HR)、平均动脉压(MAP)]及不良反应状况。结果:研究组T_(3)~T_(7)时BPS、RASS评分优于对照组(P<0.05);研究组T_(2)~T_(6)时MAP优于对照组,T_(4)~T_(6)时HR优于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定复合瑞芬太尼镇静应用于多发肋骨骨折患者术后可发挥良好镇静、镇痛效果,维持血流动力学稳定,且无明显不良反应发生。

Objective: To analyze the application effect of dexmedetomidine combined with remifentanil in postoperative rehabilitation of patients with multiple rib fractures. Methods: From January 2021 to January 2023, 86 patients with multiple rib fractures who underwent multiple rib fractures in our hospital were selected. According to the random lottery method, they were divided into control group and study group, 43 cases in each group. The control group received continuous intravenous infusion of remifentanil, and the study group received intravenous infusion of dexmedetomidine based on the control group. The pain behavior scale(BPS), RASS score, hemodynamics [heart rate(HR), mean arterial pressure(MAP)] before treatment(T_(1)), 5 min(T_(2)), 30 min(T_(3)), 1 h(T_(4)), 3 h(T_(5)), 12 h(T_(6)), 1 d(T_(7)) and adverse reactions were compared between the two groups. Results: The scores of BPS and RASS in the study group were better than those in the control group at T_(3)-T_(7)(P<0.05). MAP in the study group was better than that in the control group at T_(2)-T_(6), and HR was better than that in the control group at T_(4)-T_(6)(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Dexmedetomidine combined with remifentanil for sedation in patients with multiple rib fractures after surgery can play a good sedative and analgesic effect, maintain hemodynamic stability, and no obvious adverse reactions occur.