右美托咪定结合氟比洛芬酯在局麻下多颗复杂牙拔除术中的应用效果评价

Evaluation of the application of dexmedetomidine combined with flurbiprofen axetil in extraction of multiplecomplex teeth under local anesthesia

目的:研究右美托咪定结合氟比洛芬酯辅助镇静镇痛在局麻下多颗复杂牙拔除术中的有效性和安全性。方法:依照纳入和排除标准,将40例多颗(4~6)复杂牙拔除术患者随机分为2组(n=20),实验组(右美托咪定结合氟比洛芬酯辅助镇静镇痛组)和对照组(单纯局麻组):记录4个时间点T0(术前)、T1(局麻麻醉时)、T2(手术操作时)T3(术后10 min)的平均动脉压(MAP)、心率(HR).Ramsay评分VAS评分、回访结果。采用SAS 8.0软件包对数据进行统计学分析。结果:实验组从T1-T3,与T0时及对照组同时段相比,情绪稳定、血流动力学更平稳、镇痛效果更佳(P<0.05)。对照组术中血压升高、心率加快、情绪波动大、有身体及面部疼痛表现,与术前相比,差异显著(P<0.05)。回访结果,对照组5例服用止痛药,实验组0例(P<0.05)。结论:右美托咪定结合氟比洛芬酯辅助镇静镇痛用于局麻下多颗复杂牙拔除安全有效。

PURPOSE: To evaluate the safety and efficacy of sedation and analgesia using dexmedetomidine combined with flurbiprofen axetil in multiple complex teeth extraction under local anesthesia. METHODS: According to the inclusion and exclusion criteria of the study, 40 patients scheduled for multiple complex teeth(4-6) extraction were randomly divided into 2 groups: experimental group(sedation and analgesia using dexmedetomidine combined with flurbiprofen axetil in addition to local anesthesia, n =20) and control group(local anesthesia, n =20). The mean arterial pressure(MAP), heart rate(HR), Ramsay sedation score, VAS pain score of each patient at T0(basis value), T1(during local anesthesia), T2(during extraction), T3(10 minutes after extraction) and the follow-up results were recorded. SAS 8.0 software was used for statistical analysis. RESULTS: Compared to T0 and control group at the same time, the experimental group revealed more stable mood and hemodynamic manifestation and better analgesic effect(P<0.05), from T1 to T3, patients in the control group showed increased blood pressure, heart rate, emotional fluctuation, bodily and facial pain( P<0.05). The follow-up results showed 5 and 0 patients taking painkillers in the control and experimental group, respectively(P<0.05).CONCLUSIONS: Sedation and analgesia using dexmedetomidine combined with flurbiprofen axetil in addition to local anesthesia is a safe and effective approach in multiple complex teeth extraction.