不同剂量的右美托咪定复合七氟醚在颌面外科手术中的麻醉效果观察

Anesthetic effect of different doses of dexmedetomidine combined with sevoflurane in maxillofacial surgery

目的比较两种剂量的右美托咪定复合七氟醚在颌面外科手术中的麻醉效果。方法选择2018年1月~2020年9月纳入80例患者为研究对象,按照随机数字表法分为2组。2组根据右美托咪定的用量不同分为高剂量组(0.5μg/kg),低剂量组(0.3μg/kg)。比较两组患者围手术期的生命体征变化及麻醉相关指标。结果 T_(0)~T_(2)时,两组患者MAP、HR、SpO_(2)先降低后升高,但同一时间点组间比较差异无统计学意义(P>0.05)。T_(3)、T_(4)时,高剂量组MAP、HR均低于低剂量组,SpO_(2)高于低剂量组,差异有统计意义(P<0.05)。高剂量组拔管时间(17.4±2.1)min长于低剂量组(13.5±2.6)min,术后清醒时间(22.6±2.7)min长于低剂量组(19.6±2.5)min,差异均有统计学意义(P<0.05)。高剂量组术后6h时疼痛评分(3.8±0.5)分低于低剂量组(5.2±0.9)分;躁动评分(4.5±0.6)分低于低剂量组(6.4±1.1)分。高剂量组术后48h内发生恶心呕吐2例,低于低剂量组10例,差异具有统计学意义(P>0.05)。结论 0.5μg/kg右美托咪定复合七氟醚在颌面外科手术中的麻醉效果更佳。

Objective To compare the anesthetic effect of two doses of dexmedetomidine combined with sevoflurane in maxillofacial surgery.Methods A total of 80 patients from January 2018 to September 2020 were selected and randomly divided into two groups.The two groups were divided into high-dose group(0.5μg/kg),low dose group(0.3μg/kg)。The changes of vital signs and anesthesia related indexes were compared between the two groups.Results At T_(0)-T_(2),map,HR and SpO_(2) in the two groups decreased first and then increased,but there was no significant difference between the two groups at the same time point(P>0.05).At T_(3) and T_(4),map and HR of high-dose group were lower than those of low-dose group,SpO_(2) was higher than that of low-dose group,the difference was statistically significant(P<0.05).The extubation time of high-dose group was(17.4±2.1)min was longer than that in low dose group(13.5±2.6)min,postoperative awake time(22.6±2.7)min was longer than that in low dose group(19.6±2.5),The difference was statistically significant(P<0.05).In the high-dose group,the pain score at 6 hours after operation was(3.8±0.5)was lower than that of low dose group(5.2±0.9)points;Agitation score(4.5±0.6)was lower than that of low dose group(6.4±1.1)points.There were 2 cases of nausea and vomiting in the high-dose group within 48 hours after operation,which was lower than 10 cases in the low-dose group,and the difference was statistically significant(P>0.05).Conclusion 0.5μg/kg anesthesia effect of dexmedetomidine combined with sevoflurane in maxillofacial surgery is better.