丙泊酚与氢吗啡酮联合用于口腔颌面外科术后留置气管导管患者的临床研究

目的:探讨丙泊酚与氢吗啡酮联合用于口腔颌面外科术后留置气管导管患者镇静及镇痛的作用。方法:将口腔颌面外科术后留置气管导管患者40例患者按照随机原则分为丙泊酚-氢吗啡酮组(P-H组,20例)、丙泊酚-右美托咪定(P-D组,20例)。P-H组以异丙酚0.5～1mg/Kg·h^-1持续泵注复合氢吗啡酮4～8μg/kg·h^-1持续泵注;P-D组以异丙酚0.5～1mg/Kg·h^-1持续泵注复合右美托咪定0.2～0.6μg/kg·h^-1持续泵注。比较2组患者的Ramsay评分、心率、血压、呼吸等变化。采用SPSS16.0软件包对数据进行统计学处理。结果:在拔管前2组的动脉血pH值、氧分压、二氧化碳分压无显著差异;2组间各时点SPO2、MAP、RR、RAMSAY比较无显著差异,2组间HR在T2、T5、T6时点比较有显著差异(P<0.05)。结论:静脉泵注丙泊酚-氢吗啡酮可以取得静脉泵注丙泊酚-右美托咪定类似的临床疗效,且无减慢心率的作用。

Propofol Plus Hydromorphone for Postoperative Patients with Tracheostomy Tube in Oral and Maxillofacial Surgery: a Clinical Study.

Objective: To investigate sedative, analgesic effects of propofol plus hydromorphone given to postoperative patients with tracheostomy tube in oral and maxillofacial surgery. Methods: Forty patients with endotracheal tube after surgical treatment in oral and maxillofacial surgery were randomly divided into P-H group (propofol plus hydromorphone), P-D group (propofol plus dexmedetomidnie). P-H group received propofol 0.5-1.0 mg/kg/h intravenous infusion plus hydromorphone 4-8μg/kg/h, and P-D group received propofol 0.5-1.0 mg/kg/h intravenous infusion plus dexmedetomidnie 0.2-0.6μg/kg/h. Ramsay score, heart rate, blood pressure, respiratory and other changes were compared between two groups. Time check points included before administration (T0), 30 minutes after administration (T1), 1 hour after administration (T2), 2 hours after administration (T3), 6 hours after administration (T4), 12 hours after administration (T5) and 10 minutes after extubation (T6). The data were processed with SPSS 16.0 software package. Results: There was no significant difference for arterial blood gas analysis, oxygen saturation, mean arterial pressure, respiratory rate and ramsay score between two groups at all time points. However,the changes of heart rate were significantly different between the two groups at T2,T5 and T6. Conclusion: Similar sedative and analgesic effects can be gained in treating postoperative patients with tracheostomy tube in oral and maxillofacial surgery with P-H compared to with P-D. Besides, the former does not result in bradycardia.