右美托咪定联合地塞米松控制吸脂手术术后疼痛及术后寒战的随机对照试验  

Randomized controlled trial of dexmedetomidine combined with dexamethasone in the control of postoperative pain and postoperative shivering after liposuction

作　　者：苏祥永 杨立杰 SU Xiang-yong;YANG Li-jie(Department of Anesthesiology,Suzhou Meilai Beauty Hospital,Jiangsu Province,215004,China)

机构地区：[1]苏州美莱美容医院麻醉科,江苏苏州215004

出　　处：《中国医疗美容》2021年第12期9-12,共4页China Medical Cosmetology

摘　　要：目的评价右美托咪定联合地塞米松对吸脂手术术后疼痛及术后寒战的影响。方法纳入2020年1月~2021年1月拟于我院行吸脂手术的患者共计90例。纳入标准:年龄18~35岁,ASA分级I~II级,体重指数(body mass index,BMI)>27.9kg/m^(2)、择期行吸脂手术的患者。患者随机分为右美托咪定联合地塞米松组(D+D组)、右美托咪定组(D组)和空白对照组(C组),每组各30例患者。D组于麻醉诱导开始时泵注负荷剂量右美托咪定1 ug/kg,泵注时间10 min。负荷剂量泵注完成后调整右美托咪定泵注剂量为0.5 ug·kg^(-1)·h^(-1)。D+D组患者右美托咪定用药策略与D组患者相同,同时在麻醉诱导时静脉注射地塞米松5mg。C组患者术中全程泵注0.9%氯化钠注射液。于复苏室内(T0)、术后1h(T1)、术后2h(T2)、术后6h(T6)、术后12h(T12)使用视觉模拟评分法(visual analogue scale,VAS)评估患者术后疼痛程度。记录三组患者术后寒战、术后恶心呕吐(Postoperative nausea and vomiting,PONV)、苏醒期躁动、苏醒延迟、术后低血压发生情况。使用Wrench寒战分级评价复苏室内寒战程度。结果D+D组和D组T1、T2时点VAS明显低于C组患者,差异有统计学意义(P<0.05)。D+D组T6时点VAS明显低于D组和C组患者,差异有统计学意义(P<0.05)。D+D组和D组患者术后寒战、PONV、苏醒期躁动发生率明显低于C组患者,差异有统计学意义(P<0.05)。三组患者苏醒延迟、术后低血压发生率的比较差异无统计学意义(P>0.05)。D+D组和D组患者Wrench寒战分级0级人数显著高于C组患者,差异有统计学意义(P<0.05)。D+D组和D组患者Wrench寒战分级2级人数显著低于C组患者,差异有统计学意义(P<0.05)。结论右美托咪定联合地塞米松能够发挥良好的术后镇痛效果,有效抑制吸脂手术术后寒战的发生。Objective To evaluate the effect of dexmedetomidine combined with dexamethasone on postoperative pain and postoperative shivering after liposuction.Methods A total of 90 patients who planned to undergo liposuction in our hospital from January 2020 to January 2021 were included.Inclusion criteria:18~35 years old,ASA grade I~II,body mass index(BMI)>27.9kg/m^(2),and patients undergoing elective liposuction surgery.Patients were randomly divided into dexmedetomidine combined with dexamethasone group(Group D+D),dexmedetomidine group(group D)and control group(group C),with 30 patients in each group.In group D,the loading dose of dexmedetomidine was 1ug/kg at the beginning of anesthesia induction,and the pumping time was 10min.After loading dose pumping,the infusion dose of dexmedetomidine was adjusted to 0.5ug·kg-1·h-1.Patients in the D+D group had the same medication strategy for dexmedetomidine as those in the D group,and dexamethasone 5mg intravenously during anesthesia induction.In group C,0.9%sodium chloride injection was pumped throughout the operation.Postoperative pain was assessed by visual analogue scale(VAS)in the resuscitation room(T0),1h(T1),2h(T2),6h(T6),and 12h(T12).Postoperative shivering,Postoperative nausea and vomiting(PONV),emergence agitation during recovery,delayed recovery and Postoperative hypotension were recorded in three groups.Use Wrench shivering scale to evaluate the degree of shivering in resuscitation room.Results VAS at T1 and T2 in group D+D and group D were significantly lower than that in group C,the difference was statistically significant(P<0.05).VAS at T6 in D+D group was significantly lower than that in D group and C group,the difference was statistically significant(P<0.05).The incidence of postoperative shivering,PONV and agitation in D+D group and D group was significantly lower than that in C group,the difference was statistically significant(P<0.05).There were no significant differences in the incidence of delayed recovery and postoperative hypotension among the three grou

关 键 词：右美托咪定 地塞米松 吸脂手术 术后疼痛 寒战 

分 类 号：R614[医药卫生—麻醉学]