右美托咪定减少面部整形手术患者麻醉苏醒期躁动效果及安全性研究

Effect and safety of dexmedetomidine in reducing restlessness during anesthesia recovery in patients with facial plastic surgery

目的探究右美托咪定减少面部整形手术患者麻醉苏醒期躁动效果及安全性。方法选取2018年4月至2020年6月本院收治的面部整形手术患者117例。随机分为观察组(60例)和对照组(57例),两组均采用相同手术方式及麻醉期用药,观察组在围麻醉期加用右美托咪定。观察两组血压与心率情况、苏醒时间、拔管时间、自主呼吸恢复时间、拔管时镇静-躁动情况、疼痛情况、镇静程度、苏醒期躁动评级情况济不良反应。结果麻醉诱导后10 min、拔管时观察组收缩压、舒张压、心率低于对照组,差异有统计学意义(P<0.05)。观察组SAS评分、VAS评分低于对照组,Ramsay评分高于对照组,差异有统计学意义(P<0.05)。观察组总躁动发生率(15.00%)低于对照组(57.89%),差异有统计学意义(P<0.05)。两组总不良发生率比较,差异无统计学意义(P>0.05)。结论右美托咪定能够有效减少面部整形手术患者麻醉苏醒期躁动情况,镇静效果较好,对血压与心率影响较小,可减轻术后疼痛,且不良反应较小。

Objective To explore the effect and safety of dexmedetomidine in reducing restlessness during anesthesia recover in patients with facial plastic surgery.Methods One hundred and seventeen patients with facial plastic surgery admitted to our hospital from April 2018 to June 2020 were selected and randomly divided into observation group(60 cases)and control group(57 cases).The two groups were treated with the same operation method and medication during anesthesia.The blood pressure and heart rate,recovery time,extubation time,spontaneous respiration recovery time,sedation-restlessness during extubation,pain,sedation,and agitation rating during the recovery period were observed in the two groups.Results The systolic blood pressure,diastolic blood pressure,and heart rate of the observation group were lower than those of the control group at 10 minutes after induction of anesthesia and at the time of extubation(P<0.05).The SAS score and VAS score of the observation group were lower than those of the control group,and the Ramsay score was higher than that of the control group(P<0.05).The total incidence of restlessness in the observation group was lower than that in the control group(15.00%vs.57.89%,P<0.05).There was no significant difference in the total incidence of adverse effects between the two groups(P>0.05).Conclusion Dexmedetomidine can effectively reduce restlessness in patients undergoing anesthesia during facial plastic surgery,has a better sedative effect and less effect on blood pressure and heart rate,and reduce postoperative pain withless adverse reactions.