镇静镇痛麻醉用于俯卧位整形外科手术的可行性和安全性

Feasibility and Safety of Sedation and Analgesia for Plastic Surgery in Prone Position

目的分析镇静镇痛麻醉在俯卧位整形外科手术中应用的可行性和安全性。方法选择62例女性为研究对象,根据手术体位分为俯卧位和仰卧位两组,每组均31例。所有研究对象选择静脉输入咪唑安定0.04 mg/kg,同时持续泵注0.1μg/kg瑞芬太尼,静脉输注右美托咪定1μg/kg 15 min,之后每小时0.4~0.7μg/kg静脉持续泵注。比较两组研究对象的麻醉效果和安全性。结果对于两组研究对象的镇静剂起效时间和苏醒事件进行评价,两组研究对象差异无统计学意义,P>0.05;对于两组研究对象的不同时段的HR和MAP情况进行比较,两组研究对象差异无统计学意义,P>0.05;本研究当中,两组研究对象的镇静效果均满意,具有较好的配合度,俯卧位组在苏醒期出现了2例惊醒躁动情况,经过处理没有大碍。结论镇静镇痛麻醉应用在俯卧位整形外科手术当中具有同样的安全有效性。

Objective To analyze the feasibility and safety of sedative and analgesic anesthesia in the operation of prone position plastic surgery. Methods 62 female subjects were selected, and the positions were divided into two groups： prone position and supine position, with 31 cases in each group. All the subjects selected intravenous imidazolam, 0.04 mg/kg, and continuous pump injection of 0.1 μg/kg remifentanil, intravenous infusion of dexmedetomidine 1 μg/kg 15 minutes, followed by a continuous pump infusion of 0.4~0.7 μg/kg per hour. The anesthetic effect and safety of the two groups were compared. Results The onset time and awakening events of the two groups were evaluated. The difference between the two groups was not statistically significant, P〈 0.05; HR and MAP were compared between the two groups at different times. The difference between the two groups was not statistically significant, P〈 0.05; In this study, the two groups of subjects were satisfied with the effect of sedation, with a better coordination degree, the prone position in the awakening period appeared 2 cases of awakening agitation, after treatment was not serious. Conclusion Sedative and analgesic anesthesia has the same safety and efficacy in the surgical operation of prone position plastic surgery, and it is worth popularizing and applying.