不同联合麻醉方案对下颌骨良性病变切除术患者的影响

Effect of Different Combined Anesthesia Schemes on Patients Undergoing Mandibular Benign Lesion Resection

目的:探讨比较下牙槽神经阻滞复合静脉全身麻醉与局部浸润复合静脉全身麻醉对下颌骨良性病变切除术患者的影响。方法:回顾性分析2021年11月—2022年11月于厦门医学院附属口腔医院行下颌骨良性病变切除术的80例患者的临床资料。根据麻醉方式分为A组(局部浸润复合静脉全身麻醉,n=42)和B组(下牙槽神经阻滞复合静脉全身麻醉,n=38)。比较两组术中情况、麻醉药用量情况、拔管时间、拔管即刻和拔管后15 min的Aldrete评分及术后1 h、6 h、24 h的疼痛视觉模拟评分法(VAS)评分。结果:两组手术时间、麻醉时间、术中出血量比较,差异无统计学意义(P>0.05)。B组丙泊酚和瑞芬太尼用量少于A组,拔管时间早于A组,差异有统计学意义(P<0.05)。拔管即刻,两组Aldrete评分比较,差异无统计学意义(P>0.05);拔管后15 min,B组Aldrete评分高于A组,差异有统计学意义(P<0.05)。术后1 h、6 h,B组VAS评分均低于A组,差异有统计学意义(P<0.05);术后24 h,两组VAS评分比较,差异无统计学意义(P>0.05)。结论:与局部浸润复合静脉全身麻醉相比,下牙槽神经阻滞复合静脉全身麻醉可以减少下颌骨良性病变切除术患者术中麻醉药的用量,缩短拔管时间,苏醒更完全,术后镇痛效果更好。

Objective:To explore and compare the effects of inferior alveolar nerve block combined with intravenous general anesthesia and local infiltration combined with intravenous general anesthesia on patients undergoing mandibular benign lesion resection.Method:Retrospective analysis of the clinical data of 80 patients who underwent mandibular benign lesion resection at Stomatological Hospital of Xiamen Medical College from November 2021 to November 2022.According to the anesthesia method,they were divided into group A(local infiltration combined with intravenous general anesthesia,n=42)and group B(inferior alveolar nerve block combined with intravenous general anesthesia,n=38).The intraoperative condition,anesthetic dosage,extubation time,Aldrete score at immediately and 15 min after extubation,and the pain visual analogue scale(VAS)at 1 h,6 h,and 24 h after operation were compared between the two groups.Result:There were no statistically significant differences in surgical time,anesthesia time,and intraoperative bleeding volume between the two groups(P>0.05).The dosage of Propofol and Remifentanil in group B were less than those in group A,and the extubation time was earlier than that in group A,the differences were statistically significant(P<0.05).Immediately after extubation,there was no statistically significant difference in Aldrete scores between the two groups(P>0.05).At 15 min after extubation,the Aldrete score in group B was higher than that in group A,the difference was statistically significant(P<0.05).At 1 h and 6 h after operation,the VAS score in group B were lower than those in group A,and the differences were statistically significant(P<0.05).At 24 h after operation,there was no statistically significant difference in VAS scores between the two groups(P>0.05).Conclusion:Compared with local infiltration combined with intravenous general anesthesia,inferior alveolar nerve block combined with intravenous general anesthesia can reduce the amount of anesthetic in the operation of patients with mandibular benign lesion resection,shorten the extubation time,more complete awakening and have better postoperative analgesic effect.