右美托咪定复合瑞芬太尼在软组织射频热凝+拨针治疗中的应用

Effects of Dexmedetomidine and Remifentanil on Soft Tissue Radiofrequency plus Dial Needle Therapy

目的观察右美托咪定复合瑞芬太尼用于软组织射频热凝+拨针治疗的临床效果。方法选择行软组织射频热凝+拨针治疗的患者60例,依麻醉方式分为咪达唑仑复合瑞芬太尼组(A组)和右美托咪定复合瑞芬太尼组(B组),每组各30例。记录给药前(T0)、给药后5 min(T1)、10 min(T2)、30 min(T3)、50 min(T4)各时点心率(HR),指脉氧饱和度(SPO2),无创平均动脉压(MAP),呼吸频率(RR),手术时间,苏醒时间,瑞芬太尼的总用量,麻醉后不良反应及并发症,患者苏醒即刻视觉疼痛评分(VAS)。结果两组RR、SPO2、手术时间、苏醒时间无差异性;与T0相比,两组T1时点的RR、HR、MAP均下降(P<0.05);与A组相比,B组MAP、HR下降(P<0.05),不良反应发生率,瑞芬太尼总用量B组少于A组(P<0.05),患者苏醒即刻视觉疼痛评分(VAS)B组低于A组(P<0.05)。结论右美托咪定复合瑞芬太尼用于软组织射频热凝+拨针治疗,是一种安全有效的清醒镇静镇痛方法,值得临床推广。

Objective To observe the effects of dexmedetomidine and remifentanil on soft tissue of radiofrequency thermocoagulation plus dial needle therapy.Methods 60 cases of ASA Ⅰ-Ⅲlevel for soft tissue radiofrequency thermocoagulation plus dial needle therapy were randomly divided into two groups,midazolam and remifentanil group （ A） ,dexmedetomidine and remifen-tanil group （ B）;recorded before administration （ T0） ,after administration of 5 min （ T1） ,10 min （ T2 ） , 30 min （ T3 ） , 50 min （ T4 ） the heart rate （ HR ） and finger pulse oxygen saturation （SPO2）,a noninvasivemean arterial pressure （MAP）;respiratory rate （RR）;operation time;recovery time;the total dosage of remifentanil adverse reaction and complication after anesthe-sia;analepsia immediate visual pain score （ VAS） .Results There was no difference in RR,SPO2 , operation time,recovery time between the two groups;compared with the prior to induction, RR,HR,MAP in two groups decreased （ P〈0.05 ）;induced sleep compared with A group, B group,MAP,HR decreased （P〈0.05）,the incidence of adverse reactions,dosage of remifen-tanil total B group were less than that in group A （P〈0.05）,analepsia immediate visual pain score （ VAS） of group B was lower than that of group A （ P〈0.05） .Conclusion For soft tissue radiofrequency thermocoagulation plus dial needle therapy, Dexmedetomidine and remifentanil is a safe and effective method with conscious sedation and analgesia.