Efficacy of midazolam combined with remifentanil in the control of spasm in patients with tetanus
DING Mao-qian
YAO Yuan-zhang
QU Ji-fu
Li Yin-yan
CHEN Zhi
LI Yong
Abstract：Objective To investigate the effect of midazolam combined with remifentanil on the control of spasm in adult patients with tetanus.Methods Twenty-two adult patients with tetanus (mild,moderate,severe) were studied from Jul.2012 to Nov.2015.These patients were treated by continuous micro pump infusion of midazolam combined with remifentanil for sedation and analgesia.The changes of vital signs,the frequency and duration of spasm,the Ramsay sedation score and the size of mouth opening were observed before and after treatment.Results All the patients had an average medication of (13.5±3.2) d and mean Ramsay sedation score of (3.2±1.3)points.Compared with before treatment,the seizure frequency was significantly reduced,the duration was significantly shorter,and the mouth opening increased gradually after medication(P>0.05).Blood pressure and heart rate were significantly decreased(P<0.05).Respiratory and CVP changes were not significant before and after treatment(P>0.05).All patients were cured.There was no severe complication or death in this study.Conclusion Continuous intravenous infusion of midazolam combined with remifentanil under strict monitoring provides a safe and effective method in the treatment of tetanus patients.This treatment can achieve better sedation and analgesia and can control spasm effect.
Keywords：tetanusmidazolamremifentanilspasmsedation
Publication Date：2017-01-01