右美托咪定与硝酸甘油用于正颌手术麻醉中的控制性降压效果及对血流动力学的影响

Controlled Hypotensive Effect of Dexmedetomidine and Nitroglycerin in Orthognathic Surgery Anesthesia and Its Effect on Hemodynamics

目的 探讨正颌手术麻醉中右美托咪定与硝酸甘油的应用效果。方法 回顾性选取2019年10月—2022年8月厦门医学院附属口腔医院收治的56例正颌手术麻醉患者的临床资料,根据控制性降压方式分为对照组和观察组,每组28例。对照组用硝酸甘油实施控制性降压,观察组用右美托咪定联合硝酸甘油实施控制性降压,比较两组患者达到降压目标时的心率、停药后血压恢复时间、达到目标血压时间及不良反应情况。结果 达到降压目标时,观察组心率低于对照组,差异有统计学意义(P<0.05)。观察组停药血压恢复时间(4.62±1.02)min、达到目标血压时间(5.46±1.23)min均少于对照组,差异有统计学意义(t=7.572、7.254,P<0.05)。拔管后30 min,观察组Ricker镇静-躁动评分明显低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论 对正颌手术患者,术后以右美托咪定联合硝酸甘油实施控制性降压,具有降压效果好,血流动力学稳定,不易出现不良反应。

Objective To investigate the application of dexmedetomidine and nitroglycerin in orthognathic surgery anesthesia.Methods The clinical data of 56 patients with orthognathic operation anesthesia admitted to the Stomatology Hospital of Xiamen Medical College from October 2019 to August 2022 were retrospective selected,and were divided into control group and observation group according to the controlled hypotension method,with 28 cases in each group.The control group was treated with nitroglycerin for controlled hypotension,and the observation group was treated with dexmedetomidine combined with nitroglycerin for controlled hypotension.The heart rate,blood pressure recovery time after drug withdrawal,time to reach the target blood pressure and adverse reactions of the two groups were compared.Results The heart rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).The blood pressure recovery time(4.62±1.02) min and the time to reach the target blood pressure(5.46±1.23) min in the observation group were less than those in the control group,and the differences were statistically significant(t=7.572,7.254,P<0.05).30 min after extubation,Ricker sedation-agitation score in the observation group was significantly lower than that in the control group.and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion For patients undergoing orthognathic surgery,controlled hypotension with dexmedetomidine combined with nitroglycerin has good hypotensive effect,stable hemodynamics and is not prone to adverse reactions.