摘要
目的分析丙泊酚结合舒芬太尼麻醉对美容整形手术患者镇痛镇静效果及不良事件发生情况的影响。方法选择2019年1月至2021年1月收治的82例美容整形手术患者为研究对象,随机将其分为对照组(n=41,氯胺酮+丙泊酚)与试验组(n=41,丙泊酚+舒芬太尼)。比较两组患者不同时间点的血流动力学指标、镇痛镇静效果、应激反应指标,不良事件发生情况,以及麻醉诱导前、术后24 h的疼痛介质水平。结果用药10 min(T_(1))、用药30 min(T_(2))、手术结束时(T3),试验组的心率(HR)低于对照组,平均动脉压(MAP)高于对照组,差异具有统计学意义(P<0.05)。T_(1)~T3时,试验组的视觉模拟评分法(VAS)评分低于对照组,Ramsay评分高于对照组,差异具有统计学意义(P<0.05)。T_(1)~T3时,试验组的皮质醇(Cor)、去甲肾上腺素(NE)水平低于对照组,差异具有统计学意义(P<0.05)。试验组的不良事件总发生率为7.32%,低于对照组的24.39%,差异具有统计学意义(P<0.05)。术后24 h,两组的P物质(SP)、前列腺素E_(2)(PGE_(2))以及5-羟色胺(5-HT)水平均升高,但试验组低于对照组,差异具有统计学意义(P<0.05)。结论相较于氯胺酮+丙泊酚,丙泊酚+舒芬太尼用于美容整形手术中的麻醉效果更理想,可改善血流动力学以及应激反应,减轻患者的疼痛程度,值得临床进一步推广应用。
Objective To analyze the influences of propofol combined with sufentanil anesthesia on analgesia and sedation effect and occurrence of adverse events in patients undergoing cosmetic plastic surgery.Methods A total of 82 patients underwant cosmetic plastic surgery from January 2019 to January 2021 were selected as the study objects.The patients were randomly divided into control group(n=41,ketamine+propofol)and experimental group(n=41,propofol+sufentanil).The hemodynamic indexes,analgesic and sedative effect,stress response indexes at different time points,occurrence of adverse events,and pain mediators levels before anesthesia induction and 24 h after surgery were compared between the two groups.Results At 10 min after administration(T_(1)),30 min after administration(T_(2))and the end of the operation(T_(3)),the heart rate(HR)of the experimental group was lower than that of the control group,the mean arterial pressure(MAP)was higher than that of the control group,and the differences were statistically significant(P<0.05).At T_(1)-T_(3),the visual analogue scale(VAS)score of the experimental group was lower than that of the control group,the Ramsay score was higher than that of the control group,and the differences were statistically significant(P<0.05).At T_(1)-T_(3),the levels of cortisol(Cor)and norepinephrine(NE)in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse events in the experimental group was 7.32%,which was lower than 24.39%in the control group,the difference was statistically significant(P<0.05).At 24 h after operation,the levels of substance P(SP),prostaglandin E_(2)(PGE_(2))and 5-hydroxytryptamine(5-HT)in the two groups increased,but those in the experimental group were lower than the control group,the differences were statistically significant(P<0.05).Conclusion Compared with ketamine+propofol,propofol+sufentanil has a better anesthetic effect in cosmetic plastic surgery.It can improve the hemodynamics and stress response,and reduce the pain degree of patients,which is worthy of further clinical promotion and application.
作者
王宇
王运帷
曹鹏
高永春
WANG Yu;WANG Yunwei;CAO Peng;GAO Yongchun(Anesthesiology Department,Yan'an People's Hospital,Yan'an 716000;Burns and Cutaneous Surgery Department,Burn Center of PLA,the First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032;Burns Plastic Cosmetic Department,General Hospital of Ningxia Medical University,Yinchuan 750004,China)
出处
《临床医学研究与实践》
2022年第20期92-95,共4页
Clinical Research and Practice
关键词
美容整形手术
丙泊酚
舒芬太尼
镇痛镇静
cosmetic plastic surgery
propofol
sufentanil
analgesia and sedation
