右美托咪定对硅胶囊隆乳术患者术后早期情绪反应的影响  

Effect of dexmedetomidine on early emotional reaction in patients undergone breast augmentation with silicon gel prosthesis

作　　者：程磊[1] 胡惠英[1] 李建华[1] 李斌[1] 吴坛光[1] 

机构地区：[1]解放军第一六一医院麻醉科,湖北武汉430010

出　　处：《中国美容整形外科杂志》2014年第4期210-213,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨右美托咪定对硅胶囊隆乳术患者术后早期情绪反应的影响。方法60例择期全身麻醉下行硅胶囊隆乳术患者，ASA分级I、Ⅱ级，年龄18～48岁。麻醉诱导和维持分别采用右美托咪定组（A组）和丙泊酚组（B组）。同时均吸入七氟烷，术后两组患者静脉镇痛用药方案相同。术前1d及术后48h内，使用医院焦虑抑郁量表（HAD）评估患者情绪反应（虑、抑郁状态），使用QoR-40调查问卷评估术后恢复情况，术后30min，采用视觉模拟评分法（VAS）测定疼痛程度，采用Ramsay法评估镇静程度，并记录所有患者麻醉结束至拔管的时间，拔管时呛咳，苏醒期躁动谵妄，术后30rain内镇静、头晕、恶心、呕吐、复视、幻觉等不良反应情况。结果A组患者术后48h医院焦虑抑郁量表焦虑（HAD—A）评分、抑郁（HAD—D）评分均低于B组，差异有统计学意义（P〈0．05）；术后48h两组患者QoR40总分无统计学意义（P〉0．05），但A组患者术后48hQoR-40情绪状态评分高于B组（P〈0．05）；A组患者拔管后30nlin时疼痛VAS评分低于B组（P〈0．05），术后30rain镇静评分两组患者无统计学意义（P〉0．05）；两组患者麻醉后拔管时间、拔管后呛咳、苏醒期躁动及谵妄发生率均无统计学意义（P〉0．05）。术后30min内未见头晕、恶心、呕吐、复视等不良反应发生。结论右美托咪定可降低硅胶囊隆乳术患者手术后早期（48h内）医院焦虑抑郁量表焦虑评分（HAD—A）、抑郁评分（HAD—D）及QoR40情绪状态评分，减轻患者拔管后30min时疼痛VAS评分。提示右美托咪定可改善硅胶囊隆乳术患者全身麻醉手术后早期焦虑／抑郁情绪反应，提高术后恢复质量，有利于促进患者术后早期康复。Objective To investigate effect of dexmedetomidine on early emotional reaction in patients undergone breast augmentation with silicon gelprosthesis. Methods Under general anaesthesia, 60 patients aged from 18 to 48, （ASA I and II ） were performed the breast augmentation with silicon gel prosthesis. An- esthesia induction and maintenance were treated with dexmedetomine （ Group A, n = 30 ） and propofol group （Group B, n = 30） , respectively, both were also adopted with sevoflurane inhalation. The patients＇ emotional reaction （anxiety, depression） were assessed at the 1 st day before surgery and within 48 hours after surgery by using the Hospital Anxiety and Depression Scale. Quality of recovery, pain score and sedation were assessed u- sing the QoR-40 questionnaire, visual analog scale and Ramasay score, respectively. The complications during anesthesia and recovery such as cough, agitation, dizziness, nausea, vomiting, diplopia and hallucinations were recorded. Results The Hospital Anxiety and Depression-A score and Hospital Anxiety and Depression-D score at postoperative 48 hours in Group D was lower than those in Group B （ P 〈 0.05 ）. The QoR-40 score differences in Group A and Group B was no significant （ P 〉 0.05 ）. The patients emotional reaction QoR-40 score in Group A were higher than that in Group B （ P 〈 0.05 ）. The viasual analog scale score at 30 minutes after extubation in Group A was significantly lower than that in Group B （ P 〈 0.05 ）. However, There were no significant differences on Sedation score （ P 〉 0.05 ）. Conclusion No significant differences founded in the noted extubation time, cough, agitation and delirium, dizziness, nausea or vomiting and diplopia between the two groups.

关 键 词：右美托咪定 全身麻醉 硅胶囊假体隆乳术 

分 类 号：R614[医药卫生—麻醉学]