中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
CHINESE JOURNAL OF PLASTIC SURGERY
2014年
3期
183-186
,共4页
右美托咪定%瑞芬太尼%下睑袋整复术
右美託咪定%瑞芬太尼%下瞼袋整複術
우미탁미정%서분태니%하검대정복술
Dexmedetomidine%Remifentanil%Prosthesis of baggy deformity
目的 探讨右美托咪定复合瑞芬太尼用于睑袋整复术中可唤醒麻醉的可行性和安全性.方法 选择2010年10月至2013年3月门诊收治的50例ASA分级Ⅰ～Ⅱ级睑袋整复术患者,按随机数字表法将患者随机分为观察组和对照组2组,各25例.采用双盲法,观察组患者将右美托咪定0.8 μg/kg用输液泵10 min内泵入,然后持续静脉输注右美托咪定0.3μg·kg-1 ·h-1+瑞芬太尼0.05 μg· kg-·min 1,对照组采用1％利多卡因2 ml加1∶20万的肾上腺素局部浸润麻醉+咪达唑仑0.04 mg/kg镇静.观察2组患者术中生命体征变化,患者术中躁动和配合情况,以及术者和患者的满意度.记录手术时间、术后苏醒时间、术中术后不良反应的发生率及术中药物干预情况.结果 观察组和对照组的手术时间分别为(56.4±7.2)min和(55.6±6.8)min,苏醒时间分别为(3.0±0.23) min和(2.1±0.34) min,两者比较差异无统计学意义(P＞0.05);与对照组心率(78.2±7.6)次/min相比,观察组心率(64.2±8.2)次/min,下降明显(P＜0.05),无明显呼吸抑制(SpO2＜90％、RR ＜8次/min).观察组除有1例患者需加深麻醉外,其余24例术中均无躁动并配合术者完成手术.对照组有4例患者术中无躁动,有18例术中躁动但能配合完成手术,3例需辅助静脉药物.观察组术者和患者的满意度(96％)均明显高于对照组(24％,P ＜0.05).结论 右美托咪定复合瑞芬太尼可安全地应用于患者睑袋整复术,但应注意右美托咪定的减慢心率作用.
目的 探討右美託咪定複閤瑞芬太尼用于瞼袋整複術中可喚醒痳醉的可行性和安全性.方法 選擇2010年10月至2013年3月門診收治的50例ASA分級Ⅰ～Ⅱ級瞼袋整複術患者,按隨機數字錶法將患者隨機分為觀察組和對照組2組,各25例.採用雙盲法,觀察組患者將右美託咪定0.8 μg/kg用輸液泵10 min內泵入,然後持續靜脈輸註右美託咪定0.3μg·kg-1 ·h-1+瑞芬太尼0.05 μg· kg-·min 1,對照組採用1％利多卡因2 ml加1∶20萬的腎上腺素跼部浸潤痳醉+咪達唑崙0.04 mg/kg鎮靜.觀察2組患者術中生命體徵變化,患者術中躁動和配閤情況,以及術者和患者的滿意度.記錄手術時間、術後囌醒時間、術中術後不良反應的髮生率及術中藥物榦預情況.結果 觀察組和對照組的手術時間分彆為(56.4±7.2)min和(55.6±6.8)min,囌醒時間分彆為(3.0±0.23) min和(2.1±0.34) min,兩者比較差異無統計學意義(P＞0.05);與對照組心率(78.2±7.6)次/min相比,觀察組心率(64.2±8.2)次/min,下降明顯(P＜0.05),無明顯呼吸抑製(SpO2＜90％、RR ＜8次/min).觀察組除有1例患者需加深痳醉外,其餘24例術中均無躁動併配閤術者完成手術.對照組有4例患者術中無躁動,有18例術中躁動但能配閤完成手術,3例需輔助靜脈藥物.觀察組術者和患者的滿意度(96％)均明顯高于對照組(24％,P ＜0.05).結論 右美託咪定複閤瑞芬太尼可安全地應用于患者瞼袋整複術,但應註意右美託咪定的減慢心率作用.
목적 탐토우미탁미정복합서분태니용우검대정복술중가환성마취적가행성화안전성.방법 선택2010년10월지2013년3월문진수치적50례ASA분급Ⅰ～Ⅱ급검대정복술환자,안수궤수자표법장환자수궤분위관찰조화대조조2조,각25례.채용쌍맹법,관찰조환자장우미탁미정0.8 μg/kg용수액빙10 min내빙입,연후지속정맥수주우미탁미정0.3μg·kg-1 ·h-1+서분태니0.05 μg· kg-·min 1,대조조채용1％리다잡인2 ml가1∶20만적신상선소국부침윤마취+미체서륜0.04 mg/kg진정.관찰2조환자술중생명체정변화,환자술중조동화배합정황,이급술자화환자적만의도.기록수술시간、술후소성시간、술중술후불량반응적발생솔급술중약물간예정황.결과 관찰조화대조조적수술시간분별위(56.4±7.2)min화(55.6±6.8)min,소성시간분별위(3.0±0.23) min화(2.1±0.34) min,량자비교차이무통계학의의(P＞0.05);여대조조심솔(78.2±7.6)차/min상비,관찰조심솔(64.2±8.2)차/min,하강명현(P＜0.05),무명현호흡억제(SpO2＜90％、RR ＜8차/min).관찰조제유1례환자수가심마취외,기여24례술중균무조동병배합술자완성수술.대조조유4례환자술중무조동,유18례술중조동단능배합완성수술,3례수보조정맥약물.관찰조술자화환자적만의도(96％)균명현고우대조조(24％,P ＜0.05).결론 우미탁미정복합서분태니가안전지응용우환자검대정복술,단응주의우미탁미정적감만심솔작용.
Objective To explore the feasibility and safety of dexmedetomidine combined with remifentanil for lower eyelid blepharoplasty.Methods 50 paticnts undergoing lower eyelid blepharoplasty ASA Ⅰ ～ Ⅱ were randomly divided into 2 groups(25 in each group)as observation group and control group.Dexmedetomidine (0.3 μg· kg-1 · h-1) and remifentanil (0.05 μg· kg-1 · min-1) were used in observation group.Local anesthesia by lidocaine (1％)combined with midazo]am (0.04 mg/kg) intravenous sedation were used in control group.HR、mean arterial pressure (MAP),heart rate (HR),breathing rate (RR),pulse oxygen saturation (SpO2) change were monitored and recorded before and after the administration of the drug,as well as at the beginning of operation,during the operation,at the end of the operation,and 5 minutes after the operation.Patients sedation degree was evaluated by Ramsay.Operation time,recovery time,the incidence of adverse reactions,the satisfaction of patients and doctors were also recorded.Results Patients had no obvious difference of intraoperative MAP、RR、SpO2 、operation time and postoperative recovery time between the two groups (P ＞ 0.05).Compared with control group,HR during the operation were decreased significantly [(64.2 ± 8.2) bprn,P ＜ 0.05] in observation group.In control group,there were 18 cases of patients with agitation,but they endured the operation anyway.In observation group,24 cases of patients underwent operation without agitation.The satisfaction of patients and the operation doctors (96％) in observation group were markedly higher than that in control group(P ＜0.05).Conclusion Dexmedetomidine combined with remifentanil is practical and safe.The effcct of reducing HR should be noticed.
