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中华神经创伤外科电子杂志 ›› 2017, Vol. 03 ›› Issue (05) : 305 -308. doi: 10.3877/cma.j.issn.2095-9141.2017.05.012

所属专题: 文献

综述

对重症颅脑创伤镇静镇痛的认识
韩敏1, 杜勇健1, 杨光诚1,()   
  1. 1. 250022 济南市第五人民医院神经外科
  • 收稿日期:2017-08-30 出版日期:2017-10-15
  • 通信作者: 杨光诚

Understanding of sedation and analgesia in traumatic brain injury

Min Han1, Yongjian Du1, Guangcheng Yang1,()   

  1. 1. Department of Neurosurgery, the 5th People’s Hospital of Ji’nan, Ji’nan 250022, China
  • Received:2017-08-30 Published:2017-10-15
  • Corresponding author: Guangcheng Yang
  • About author:
    Corresponding author: Yang Guangcheng, Email:
引用本文:

韩敏, 杜勇健, 杨光诚. 对重症颅脑创伤镇静镇痛的认识[J]. 中华神经创伤外科电子杂志, 2017, 03(05): 305-308.

Min Han, Yongjian Du, Guangcheng Yang. Understanding of sedation and analgesia in traumatic brain injury[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2017, 03(05): 305-308.

颅脑创伤是一种常见外伤,可单独存在,也可合并其他脏器伤,病情复杂多变,伤后常表现出不同程度的烦躁,导致脑耗氧量增加、颅内压升高等不良后果。因此,合理、科学的镇痛、镇静治疗尤为重要,可缓解疼痛、焦虑和躁动,降低应激反应及其对机体的损害,利于诊断、护理和治疗性操作,减少并发症,尤其对于重症患者更加有益。本文针对颅脑创伤后的病理生理、常用镇静镇痛药物、镇痛镇静治疗的新进展等几个方面进行综述。

Traumatic brain injury is a familiar injury, which can exist solely and also can combined with other organs, the disease is complex and changeable, often shows different degrees of irritability, resulting in brain oxygen consumption increase, intracranial pressure increased and other adverse consequences. Therefore, reasonable, scientific analgesic and sedative treatment is particularly important to relieve pain, anxiety and restlessness, reduce stress response and its damage to the body, facilitate diagnosis, care and treatment operations, and reduce complications, especially for severe patients. The pathological physiology, commonly used sedative, analgesic drugs, and the new progress of analgesic and sedative therapy are sum up in this paper.

[1]
Morganti-Kossmann MC,Rancan M,Stahel PF, et al. Inflammatory response in acute traumatic brain injury: a double-edged sword[J]. Curr Opin Crit Care, 2002, 8(2): 101-105.
[2]
夏婧,张玮,钱传云.镇静治疗对ICU危重患者应激的预防作用[J].临床麻醉学杂志, 2009, 25(1): 64-65.
[3]
Stephan H,Sonntag H,Schenk HD, et al. Effect of disoprivan (propofol) on the circulation and oxygen consumption of the brain and CO2 reactivity of brain vessels in the human[J]. Anaesthesist, 1987, 36(2): 60-65.
[4]
Van Hemelrijck J,Fitch W,Mattheussen M, et al. Effect of propofol on cerebral circulation and autoregulation in the baboon[J]. Anesth Analg, 1990, 71(1): 49-54.
[5]
Oddo M,Steiner LA. Sedation and analgesia in the neurocritical care unit//Smith M,Kofke WA,Citerio G, editors. Oxford textbook of neurocritical care[M]. Oxford: Oxford University Press, 2016.
[6]
Brophy GM,Bell R,Claassen J, et al. Guidelines for the evaluation and management of status epilepticus[J]. Neurocrit Care, 2012, 17(1): 3-23.
[7]
张文坡,张向宁,郭立刚.咪达唑仑在神经外科重症监护病房患者镇静中的应用[J].中国药物与临床, 2015, 15(12): 1793-1794.
[8]
Chamorro C,Borrallo JM,Romera MA, et al. Anesthesia and analgesia protocol during therapeutic hypothermia after cardiac arrest: a systematic review[J]. Anesth Analg, 2010, 110(5): 1328-1335.
[9]
Brummel NE,Girard TD. Preventing delirium in the intensive care unit[J]. Crit Care Clin, 2013, 29(1): 51-65.
[10]
Pohlman AS,Simpson KP,Hall JB. Continuous intravenous infusions of lorazepam versus midazolam for sedation during mechanical ventilatory support: a prospective, randomized study[J]. Crit Care Med, 1994, 22(8): 1241-1247.
[11]
Swart EL,Zuideveld KP,de Jongh J, et al. Comparative population pharmacokinetics of lorazepam and midazolam during long-term continuous infusion in critically ill patients[J]. Br J Clin Pharmacol, 2004, 57(2): 135-145.
[12]
Brajn Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons, et al. Guidelines for the management of severe traumatic brain injury[J]. J Neurotrauma, 2007, 24 Suppl 1: Sl-106.
[13]
Flower O,Hellings S. Sedation in traumatic brain injury[J]. Emer Med Int, 2012, 2012: 637171.
[14]
彭振丽,罗艳丽,赵立昆,等. ICU患者126例镇静镇痛药物应用体会[J].中国现代医药杂志, 2003, 5(5): 52-53.
[15]
Orsini J,Nadkarni A,chen J, et al. Propofol infusion syndrome: case report and literature review[J]. Am J Health Syst Pharm, 2009, 66(10): 908-915.
[16]
Tanguy M,Seguin P,Laviolle B, et al. Cerebral microdialysis effects of propofol versus midazolam in severe traumatic brain injury[J]. J Neurotrauma, 2012, 29(6): 1105-1110.
[17]
袁绍纪.神经重症患者的镇痛镇静[J].中华神经创伤外科电子杂志, 2015, 1(5): 317-318.
[18]
Brophy GM,Bell R,Claassen J, et al. Guidelines for the evaluation and management of status epilepticus[J]. Neurocrit Care, 2012, 17(1): 3-23.
[19]
Meierkord H,Boon P,Engelsen B, et al. EFNS guideline on the management of status epilepticus in adults[J]. Eur J Neurol, 2010, 17(3): 348-355.
[20]
Beretta L,de Vitis A,Grandi E. Sedation in neurocritical patients: is it useful?[J]. Minerva Anestesiol, 2011, 77(8): 828-834.
[21]
Skoglund K,Enblad P,Marklund N. Monitoring and sedation differences in the management of severe head injury and subarachnoid hemorrhage among neurocritical care centers[J]. J Neurosci Nurs, 2013, 45(6): 360-368.
[22]
Gottschalk A,Yaster M. Pain management after craniotomy[J]. Neurosurg Q, 2007, 17(1): 64-73.
[23]
Kamibayashi T,Maze M. Clinical uses of alpha2-adrenergic agonists[J]. Anesthesiology, 2000, 93(5): 1345-1349.
[24]
容永璋,林华新,莫玉华.右美托咪定对机械通气患者睡眠情况及澹妄发生率的影响[J].国际医药卫生导报, 2013, 19(18): 2858-2861.
[25]
周少丽谭芳陈裕洁.右美托咪定用于治疗脓毒症的研究及其进展[J].实用医学杂志, 2013, 29(15): 2421-2422.
[26]
Humble SS,Wilson LD,Leath TC, et al. ICU sedation with dexmedetomidine after severe traumatic brain injury[J]. Brain Inj, 2016: 30(10): 1266-1270.
[27]
郝江,罗积慎,翁奇,等.右美托咪定与异丙酚对颅脑创伤患者β-内啡肽水平的影响及镇静疗效对比研究[J].中华危重病急救医学, 2013, 25(6): 373-376.
[28]
Unlugenc H,Gunduz M,Guler T, et a1. The effect of pre-anaesthetic administration of intravenous dexmedetomidine on postoperative pain in patients receiving patient-controlled morphine[J]. Eur J Anaesthesiol, 2005, 22(5): 386-391.
[29]
Haselman MA. Dexmedetomidine: a useful sdjunct to consider in some high-risk situation[J]. AANA J, 2008, 76(5): 335-339.
[30]
Pajoumand M,Kufera JA,Bonds BW, et al. Dexmedetomidine as an adjunct for sedation in patients with traumatic brain injury[J]. J Trauma Acute Care Surg, 2016, 81(2): 345-351.
[31]
Lai YC,Tsai PS,Huang CJ. Effects of dexmedetomidine on regulating endotoxin-induced up-regulation of inflammatory molecules in murine macrophages[J]. J Surg Res, 2009, 154(2): 212-219.
[32]
周少丽,谭芳,陈裕洁.右美托咪定用于治疗脓毒症的研究及其进展[J].实用医学杂志, 2013, 29(15): 2421-2422.
[33]
安友仲. ICU危重患者的镇痛与镇静[J].医学新知杂志, 2007, 17(5): 252-254.
[34]
安友仲,邱海波,黄青青,等.中国重症加强治疗病房患者镇静和镇痛治疗指导意见[J].中华外科杂志, 2006, 44(17): 1158-1166.
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