The Anesthesia Effect of Dexmedetomidine Combined with Midazolam in Elderly Patients with Moderate to Severe Burns Undergoing Scab Excision and Skin Grafting Surgery
WANG Haijun
Department of Anesthesiology, Second People's Hospital of Huangchuan County, Xinyang Henan 465150
Abstract：【Objective】To investigate the anesthetic effect of dexmedetomidine (Dex) combined with midazolam in elderly patients with severe burns undergoing scab excision and skin grafting surgery. 【Methods】A total of 102 elderly patients with moderate to severe burns were randomly divided into the observation group and the control group, with 51 cases in each group. The control group was maintained with propofol anesthesia, while the observation group was maintained with Dex combined with midazolam anesthesia. The heart rate (HR) and mean arterial pressure (MAP) levels were compared between two groups at different time points during and after surgery; Two groups of patients were compared in terms of surgical conditions and plasma cortisol (COR), adrenaline (E), and norepinephrine (NE) levels before and after surgery; Two groups of patients were compared in terms of postoperative pain [visual analog scale (VAS)], sedation effect (Ramsay sedation score), agitation incidence, and incidence of adverse reactions.【Results】The HR of the observation group was lower than that of the control group at the end of surgery, before extubation, and 30 minutes after extubation (P<0.05), while the MAP was higher than that of the control group (P<0.05). At 30 minutes postoperatively, the plasma levels of COR, E, and NE in the observation group were lower than those in the control group (P<0.05). The VAS score of the observation group was lower than that of the control group (P<0.05), the Ramsay sedation score was higher than that of the control group (P<0.05), and the incidence of agitation was lower than that of the control group (P<0.05). The awakening time of the observation group was shorter than that of the control group (P<0.05), and there was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】Dex combined with midazolam can effectively reduce postoperative stress response, stabilize hemodynamics, shorten recovery time, reduce postoperative pain and agitation incidence in elderly patients with moderate to severe burns undergoing scab and skin grafting surgery, and has good safety.
王海军. 老年中重度烧伤患者切痂植皮术中使用右美托咪定联合咪达唑仑的麻醉效果[J]. 医学临床研究, 2024, 41(9): 1335-1338.
WANG Haijun. The Anesthesia Effect of Dexmedetomidine Combined with Midazolam in Elderly Patients with Moderate to Severe Burns Undergoing Scab Excision and Skin Grafting Surgery. JOURNAL OF CLINICAL RESEARCH, 2024, 41(9): 1335-1338.
[1] 王景坤,钟福如,何晓霞. 氟比洛芬酯联合舒芬太尼及右美托咪定对全麻重度烧伤切痂植皮手术患者苏醒期躁动的影响[J].中南医学科学杂志,2022,50(1):132-136. [2] TAMAYO-GOMEZ A, VELASQUEZ-SUAREZ J, PARAMO-DUQUE L, et al. Epidemiology and factors associated with acute stress disorder in burned patients:a case-control study[J].Burns,2022, 48(4):995-1003. [3] SAHAP M, GULEC H, BUT A, et al. Regional anesthesia in a patient with multiple trauma, advanced age and multiple comorbidities[J].Anaesth Pain Intens Care,2021, 25(2):222-224. [4] 宋一凡,江林昊,杨谦梓,等. 右美托咪定的中枢神经作用机制研究进展[J].上海交通大学学报(医学版),2024,44(5):626-634. [5] 李思洁. 右美托咪定和咪达唑仑在小儿磁共振检查镇静应用的研究进展[J].重庆医学,2023,52(13):2046-2050. [6] 雷彦刚,赵宁侠,樵成,等. 不同剂量右美托咪定联合咪达唑仑对精神障碍儿童头颅MRI检查镇静效果观察[J].国际医药卫生导报,2024,30(12):1999-2003. [7] 李莎,康晓静. 咪达唑仑联合右美托咪定复合气管插管麻醉下甲状腺切除术中麻醉疗效分析[J].贵州医药,2023,47(1):55-56. [8] 黄竞威,郝霞,江顺波,等. 超声引导下中医内热针治疗腰椎内固定术后腰痛的疗效分析及对血清5-HT、SP、β-EP水平的影响[J].中国现代医学杂志,2023,33(18):52-58. [9] 杨智斌,沈江涌,米克德,等. 右美托咪定复合瑞芬太尼在烧伤重症监护病房中清醒非插管患者换药时的应用研究[J].中华烧伤杂志,2018,34(10):707-713. [10] 鲍杨,张丽峰,马丽敏,等. 全身麻醉维持方式与苏醒期躁动关系的临床观察[J].国际麻醉学与复苏杂志,2016,37(3):202-204. [11] BURGESS M, VALDERA F, VARON D, et al. The immune and regenerative response to burn injury[J].Cells,2022,11(19):3073. [12] SAVETAMAL A. Infection in elderly burn patients:what do we know?[J].Sur Infect,2021, 22(1):65-68. [13] SEN B, SEN J. Dexmedetomidine for attenuation of sympathomimetic response to laryngoscopy and tracheal intubation in neurosurgical patients[J].J Datta Meghe Institute Med Sci University,2022, 17(2):399-404. [14] LUCA E, SCHIPA C, CAMBISE C, et al. Implication of age-related changes on anesthesia management[J].Saudi J Anaesth,2023, 17(4):474-481.
2024, Vol. 41 
