右美托咪啶复合舒芬太尼在假体隆乳术麻醉中的应用  

Application of dexmedetomidine combined with sufentanil inbreast augmentation anesthesia

作　　者：唐安[1] 刘玉[1] 李泰平[2] 杨冬[3] 夏建军[4] 

机构地区：[1]南京医科大学附属友谊整形外科医院麻醉科,江苏南京210029 [2]南京医科大学附属友谊整形外科医院药剂科,江苏南京210029 [3]中国医学科学院北京协和医学院整形外科医院麻醉科,北京100144 [4]南京医科大学附属友谊整形外科医院整形外科,江苏南京210029

出　　处：《中国美容整形外科杂志》2017年第8期477-479,共3页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：南京医科大学科技发展基金项目(2015NJMU176)

摘　　要：目的观察右美托咪啶复合舒芬太尼用于假体隆乳术麻醉的有效性。方法选取自2015年1~12月,采用右美托咪啶复合舒芬太尼麻醉下行假体隆乳术的60例患者为研究对象,术中观察患者OAA/S评分、血流动力学和呼吸的变化,以及有无并发症,分析其麻醉疗效。结果右美托咪啶负荷剂量输注结束后,OAA/S评分由5.0±0下降至3.5±0.3(P<0.05),术中OAA/S评分维持在2.4~3.2(P<0.05),手术结束时OAA/S评分恢复至4.5±0.4(P<0.05),但明显低于术前基础值(P<0.05)。与术前基础值相比,镇静诱导后收缩压、舒张压和呼吸无明显下降(P>0.05),心率下降明显(P<0.05)。所有患者在麻醉下完成手术,其中3例患者术中出现低氧血症,2例患者术中心率降至50次/min以下。麻醉时间为(78±21)min,右美托咪啶、舒芬太尼和咪达唑仑的用量分别为(112±38)μg、(10±5)μg和(2±1)mg。术后随访,48例患者对术中情况几乎没有记忆,12例患者对术中情况记忆模糊;98%患者愿意再次接受本麻醉方法。结论右美托咪啶复合舒芬太尼是假体隆乳手术比较理想的麻醉方法。Objective To explore the effect of dexmedetomidine combined with sufentanil in breast augmentation anesthesia.Methods From January to December 2015, 60 patients who underwent breast augmentation were involved in the study. Dexmedetomidine combined with sufentanilwas used for anesthesia in the operation. The complications and changes of the OAA/S score, hemodynamics,and respiration during the operation were observed. The anesthesic effect was analyzed. Results After dexmedetomidine infusion, the OAA/S score decreased from 5.0±0 to 3.5±0.3（P〈0.05）. The OAA/S score was maintained from 2.4 to 3.2 during the operation and returned to 4.5±0.4 when the operation finished（P〈0.05）, which was significantly lower than preoperative values（P〈0.05）. Compared with preoperative values, systolic blood pressure, diastolic blood pressure, and respiration did not significantly decrease after sedation induction（P〉0.05）, while heart rate decreased significantly（P〈0.05）. All patients completed the operation under anesthesia. Among them, 3 patients appeared hypoxemicduringthe operationand the heart rate of 2 patients dropped below 50 beats/min. The duration of anesthesia was（78±21） min,and the consumption of dexmedetomidine, sufentanil and midazolam was（112±38） μg,（10±5） μg and（2±1） mg, respectively.In postoperative follow-up, 48 patients had almost no memory of surgery, and 12 patients had a fuzzy memory of the operation.Ninety-eight percent of patients said they were willing to accept the same anesthetic technique again in the future. Conclusion Dexmedetomidine combined with sufentanilasanesthesia is an ideal method for breast augmentation surgery.

关 键 词：假体隆乳术 静脉麻醉 右美托咪啶 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]