解放军医学院学报2017，Vol.38Issue(6)：512-515,4.DOI:10.3969/j.issn.2095-5227.2017.06.006
丙泊酚联合咪唑安定短期镇静在颈动脉内膜切除术后的应用
Application of propofol combined with midazolam sedation in postoperative management of carotid endarterectomy
摘要
Abstract
Objective To evaluate the significance of short-term sedation by propofol combined with midazolam on postoperative management of carotid endarterectomy (CEA). Methods Clinical data about 308 consecutive patients undergoing CEA in our hospital from July 2007 to November 2016 were retrospectively analyzed, and they were all treated with continuous sedation of propofol and midazolam postoperatively for 4-6 hours on the basis of strict blood pressure monitor and control. The Ramsay score was used to assess sedation depth with level 6 indicating achieving sedation goal. Midazolam was discontinuously intravenous-injectd at dosage of 0.04 mg/kg every 45-60 min with a total of 3 times, and propofol was continuously intravenous pumped at 0.5-2.0 mg/(kg · h) for 4-6 hours. Results All patients came around at 3-28 minutes [(18.2±5.2) min] after withdraw of propofol, and 15-75 minutes later tracheal intubation was successfully extubated. The incidence of bucking with intubation was 10.4% in the process of sedation, and vasoactive pharmaceuticals was administered in 89.3% patients; Patients'heart rate and blood pressure were all controlled in normal range with oxygen saturation of 95%-100%. Incision bleeding was observed in 5 patients, 1 case presented with aphasia and homolateral hemiplegia, 1 case suffered from acute myocardial infarction at 2 days after operation, and 1 case caught pneumonia. No death was documented. Conclusion The present study suggests that short-term sedation by propofol combined with midazalom administration is beneficial to postoperative anesthesia recovery and strict blood pressure control, which can effectively prevent the occurrence of cranial nerve-associated complications.关键词
丙泊酚/咪唑安定/Ramsay镇静评分/颈动脉内膜切除术Key words
propofol/midazolam/Ramsay score/carotid endarterectomy分类
医药卫生引用本文复制引用
王秀英,孙正辉,刘磊,武琛,许百男..丙泊酚联合咪唑安定短期镇静在颈动脉内膜切除术后的应用[J].解放军医学院学报,2017,38(6):512-515,4.基金项目
解放军总医院临床扶持基金 (2016FC-TSYS-1022) （2016FC-TSYS-1022）
