摘要
目的探讨舒芬太尼复合丙泊酚对小面积微创吸脂手术的麻醉效果。方法选择择期行双上臂、面颊部、腰腹部吸脂整形手术的患者各20例,随机分为舒芬太尼复合丙泊酚组(A组)和瑞芬太尼复合丙泊酚组(B组),每组30例。观察麻醉前(T_0)、麻醉后2 min(T_1)、注射肿胀液时(T_2)、手术开始20 min(T_3)及手术结束时(T_4)的平均动脉压(MAP)、心率(HR)及SpO_2的变化;记录两组患者静脉麻醉镇痛与镇静效果,并观察术中呼吸抑制、肢体活动、喉痉挛、清醒时间、呛咳、术后躁动及恶心呕吐等情况。结果两组患者术中丙泊酚用量差异无统计学意义(P>0.05);与麻醉前相比,B组麻醉时MAP和HR下降较A组更显著(P<0.05);SS组在麻醉维持期间MAP和HR较B组高(P<0.05);T_1~T_3时间点,B组MAP和HR低于A组(P<0.05);T_4时间点B组MAP和HR高于A组(P<0.05);A组患者的清醒时间较B组长(P<0.05);RR组呼吸抑制、术后躁动、恶心呕吐发生率较A组显著增多(P<0.05)。结论舒芬太尼复合丙泊酚配合局部肿胀麻醉在小面积微创吸脂手术中的血流动力学更稳定,镇痛时间长,术中呼吸抑制少,术后躁动、恶心呕吐发生率低,值得在临床上推广。
Objective To investigate the anesthesic effects of sufentanil propofol compound for small area,minimally invasive liposuction surgery.Methods There are 60 patients involved in this study,including 20 cases who underwent bilateral upper arm liposuction,20 cases who underwent bilateral cheek liposuction and 20 cases who underwent waist and abdomen liposuction.These patients were divided into a sufentanil propofol compound SS group （A group） and a Remifentanil propofol compound RR group（B group）.The change of mean arterial pressure （MAP）,heart rate （HR） and SpO2 were observed at 5 time intervals：（1） before anesthesia （To）.（2） 2min after anesthesia （T1）.（3） time of injection of swelling solution （T2）.（4） 20 min after surgery began （T3）.（5） at the completion of surgery（T4）.Intravenous anesthesia analgesic and sedative effects in the two groups were recorded.Patients were monitored for ntraoperative respiratory depression,physical activity,laryngismus,waking time,choking cough,postoperative restlessness,nausea and vomiting.Results There is nostatistically significant difference between the propofol dosage in the two groups （P〉0.05）.When anesthesia was administered,MAP and HR in the RR group decreased more significantly than that in the A group,compared with the time interval prior to the administration of anesthesia （P〈0.05）.MAP and HR of the A group were higher than the B group during the anesthesia maintenance period （P〈0.05）.At the time of T1 to T3,MAP and HR in the B group were lower than that in the A group （P〈 0.05）,at the time of T4,MAP and HR in RR group were higher than that in the A group （P〈0.05）.The A group of patients with conscious B group was significantly prolonged （P〈 0.05）.The waking time of the A group was longer than the B group （P〈0.05）.The incidence of respiratory depression,postoperative restlessness,nausea and vomiting in the B group was more than that in the A group （P〈0.05）.Conclusion The application of sufentanil propofol compound combined with local swelling anesthesia in small area,minimally invasive liposuction surgery can stablize hemodynamics.It shoud be considered for promotion in clinic.This method hasthe advantage of being a long duration analgesia with less intraoperative respiratory depression,and a low incidence of postoperative restlessness,nausea or vomiting.
出处
《中国美容整形外科杂志》
CAS
2017年第3期156-159,共4页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
舒芬太尼
瑞芬太尼
局部肿胀麻醉
小面积微创吸脂
Sufentanil
Ruifentanyl
Local swelling anesthesia
Small area minimally invasive liposuction
