右美托咪定与艾司洛尔用于正颌手术术中控制性降压效果比较  

Comparison of the effects of dexmedetomidine and esmolol on controlled hypotension in patients with orthognathic surgery

作　　者：蒋珏[1] 林宇[1] 蒋超[1] JIANG Jue;LIN Yu;JIANG Chao(Department of Anesthesiology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院麻醉科,上海200011

出　　处：《上海口腔医学》2021年第5期548-550,共3页Shanghai Journal of Stomatology

摘　　要：目的:比较右美托咪定与艾司洛尔用于正颌手术中控制性降压的效果。方法:回顾2017年1月—2019年12月择期行正颌手术(上颌骨Le Fort I型截骨和下颌支矢状劈开术)术中用右美托咪定(D组)和艾司洛尔(E组)行控制性降压病例共109例,比较2组患者控制性降压期间心率(HR)和平均动脉压(MAP)波动情况(最高与最低值的差值和基础值的百分比),术中失血量、异体血输注情况、手术时间及瑞芬太尼、异丙酚使用量。采用SPSS 22.0软件包对数据进行统计学分析。结果:与E组相比,D组控制性降压期间HR和MAP的波动显著降低(P<0.05),异丙酚和瑞芬太尼使用量显著减少(P<0.05),其他指标无显著差异。结论:右美托咪定用于正颌手术术中控制性降压可使降压过程更为平稳,同时减少异丙酚和瑞芬太尼的用量。PURPOSE:To compare the effect of dexmedetomidine(Dex)and esmolol on controlled hypotension in patients with orthognathic surgery.METHODS:From January 2017 to December 2019,a total of 109 patients were treated with Dex(group D)and esmolol(group E)during orthognathic surgery(Le Fort I osteotomy of maxilla and sagittal split of mandibular ramus)in our hospital.Heart rate(HR)and mean arterial pressure(MAP)during controlled hypotension(the dif-ference between the highest and lowest values and the percentage of basic values),intraoperative blood loss,allogeneic blood transfusion,operation time and dosage of propofol and remifentanil were compared between the two groups.The data were statistically analyzed using SPSS 22.0 software package.RESULTS:Compared with group E,HR and MAP,dose of propofol and remifentanil in group D were significantly lower than those in group E(P<0.05).There was no significant difference among other indexes.CONCLUSIONS:Compared with esmolol,the effect of Dex on controlled hypotension during orthognathic surgery is more stable and the dosage of propofol and remifentanil is decreased.

关 键 词：右美托咪定 艾司洛尔 正颌手术 控制性降压 

分 类 号：R782.05[医药卫生—口腔医学]