右旋美托咪啶复合瑞芬太尼用于抽脂术麻醉的临床观察

Effectiveness of Dexmedetomidine Combined with Remifentanil in Anesthesia for Liposuction

目的探讨右旋美托咪啶复合瑞芬太尼用于抽脂术麻醉的有效性。方法将择期抽脂术患者60例,随机分为右旋美托咪啶+瑞芬太尼组(DF组)、右旋美托咪啶组(D组)和局麻组(N组),每组20例。DF组和D组麻醉开始均给予1μg/Kg负荷量的右旋美托咪啶,10 min内泵注完毕,待Ramsay镇静评分达到3分后开始手术,然后以0.5μg/Kg·h维持;DF组麻醉开始还给予瑞芬太尼0.1μg/Kg·min,术中泵注维持。N组不给予静脉麻醉药物。三组均注射局麻肿胀液。评估指标包括Ramsay镇静评分和VAS疼痛评分,记录用药前、手术开始、手术30 min、60 min和术毕的HR、MAP、SPO_2,并记录不良反应情况。结果 N组HR、MAP明显高于DF组和D组(P<0.05),DF组和D组HR、MAP和SPO_2差异无统计学意义(P>0.05)。DF组和D组VAS疼痛评分优于N组(P<0.05),DF组VAS疼痛评分优于D组(P<0.05)。各组未发生严重不良反应。结论右旋美托咪啶复合瑞芬太尼用于抽脂手术麻醉效果确切,且优于单纯使用右旋美托咪啶。

Objective To investigate the effectiveness of dexmedetomidine combined with remifentanil in the anesthesia for liposuction. Methods Sixty patients for liposuction were randomly divided into 3 groups （n=20）： dexmedetomidine＋ remifentanil group （group DF）, dexmedetomidine group （group D） and local anesthesia group （group N）. Group DF and group D were intravenously infused with 1 Ixg/Kg dexmedetomidine in ten minutes. Group DF received remifentanil 0.1 p,g/Kg.min in addition, When the Ramsay sedation score reached 3 points, operation started. The rate of dexmedetomidine was maintained 0.5 μg/（Kg .h） during the operation. No intravenous anesthetics was given in Group N. All groups were injected with tumescent fluid. Scoring criteria included Ramsay sedation score, VAS pain score and HR, MAP, SPO2 in different time point were all observed. And the adverse reactions were recorded. Results HR, MAP in group N were higher than in group DF and group D （P〈0.05）. No difference of HR, MAP and SPO2 were observed between group DF and group D （P〉0,05）. The VAS pain score in group DF and group D were both higher than in group N （P〈0.05）. The VAS pain score in group DF was also better than in group D （P〈0.05）. No serious adverse reactions were observed in all groups. Conclusion Dexmedetomidine combined with remifentanil used for liposuetion is effective, and is superior to single use of dexmedetomidine.