右美托咪定复合舒芬太尼清醒镇静术在腰腹部及大腿部微创吸脂手术中的应用  

Application of dexmedetomidine combined with sufentanil conscious sedation in minimally invasive liposuction of waist, abdomen and thigh

作　　者：余慧强 孟培 刘韩 YU Hui-qiang;MENG Pei;LIU Han(Department of Anesthesiology,Jiaozuo Second People's Hospital, Henan Province, 450000, China)

机构地区：[1]焦作市第二人民医院麻醉科

出　　处：《中国医疗美容》2019年第5期31-34,共4页China Medical Cosmetology

摘　　要：目的观察右美托咪定复合舒芬太尼清醒镇静术在腰腹部及大腿部微创吸脂手术中的应用效果。方法两组患者均采用静脉麻醉。术前建立静脉通道,监测生命体征,面罩2L/min吸氧。观察组术前静脉输注右美托咪定0.1μg/kg(10min内输注完),舒芬太尼0.1μg/kg,然后采用静脉泵持续泵入右美托咪定0.2~0.4μg·kg^-1·min^-1。对照组术前静脉注射舒芬太尼0.1μg/kg,丙泊酚1.5mg/kg,然后静脉泵入丙泊酚3~6mg·kg^-1·h^-1。结果观察组手术时间(124.3±25.6)min与对照组(129.7±27.4)min比较差异无统计学意义。观察组T1-T4时间点MAP、心率低于T0,差异有统计学意义(P <0.05)。同一时间点,对照组T1-T4MAP、心率、呼吸频率低于对照组,差异有统计学意义(P <0.05)。观察组发生低血压多于对照组,差异有统计学意义(P <0.05)。观察组对术中记忆评价为优28例、良15例、差2例,优于对照组优13例、良23例、差9例,差异有统计学意义(P <0.05)。结论腰腹部及大腿部微创吸脂手术行右美托咪定复合舒芬太尼清醒镇静术患者生命体征更平稳,术后不良反应更小,效果更贴近清醒镇静术的要求。Objective To observe the effect of dexmedetomidine combined with sufentanil sober sedation in minimally invasive liposuction of waist, abdomen and thigh. Methods Intravenous anesthesia was used in both groups. Preoperative venous access was established, vital signs were monitored, and oxygen was inhaled by mask for 2 L/min. The observation group received intravenous infusion of dexmedetomidine 0.1 ug/kg(finished within 10 minutes) and sufentanil 0.1 ug/kg before operation, and then continued infusion of dexmedetomidine 0.2-0.4 ug·kg^-1·min^-1 by intravenous pump. The control group received intravenous sufentanil 0.1 ug/kg and propofol 1.5 mg/kg before operation, and then intravenously pumped propofol 3-6 mg/kg·kg^-1·h^-1. Results There was no significant difference in operation time between the observation group(124.3 + 25.6) min and the control group(129.7 + 27.4) min. The MAP and heart rate of observation group at T1-T4 time point were lower than that of T0, and the difference was statistically significant(P< 0.05). At the same time, the T1-T4 MAP, heart rate and respiratory rate of the control group were lower than those of the control group,and the difference was statistically significant(P< 0.05). The incidence of hypotension in the observation group was higher than that in the control group(P< 0.05). The observation group had 28 excellent cases, 15 good cases and 2 poor cases in intraoperative memory evaluation, which was superior to the control group in 13 excellent cases, 23 good cases and 9 poor cases(P < 0.05). Conclusion The vital signs of patients undergoing dexmedetomidine combined with sufentanil conscious sedation for lumbar, abdominal and thigh minimally invasive liposuction are more stable, the adverse reactions are less, and the effect is closer to the requirements of conscious sedation.

关 键 词：吸脂术 腰腹部 大腿部 清醒镇静术 右美托咪定 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学] R622[医药卫生—外科学]