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

doi:10.19439/j.sjos.2021.05.020

上海口腔医学 ›› 2021, Vol. 30 ›› Issue (5): 548-550.doi: 10.19439/j.sjos.2021.05.020

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

蒋珏, 林宇^*, 蒋超^*

上海交通大学医学院附属第九人民医院麻醉科,上海 200011

收稿日期:2020-04-22 修回日期:2020-07-30 出版日期:2021-10-25 发布日期:2021-11-08
通讯作者: 林宇,E-mail:anesthesialin@163.com;蒋超,E-mail:samsmail@163.com。^*共同通信作者
作者简介:蒋珏（1978-）,男,博士,E-mail:jiangjue1136@sina.com

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

JIANG Jue, LIN Yu, JIANG Chao

Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2020-04-22 Revised:2020-07-30 Online:2021-10-25 Published:2021-11-08

摘要/Abstract

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。

关键词: 右美托咪定, 艾司洛尔, 正颌手术, 控制性降压

Abstract: 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 difference 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.

Key words: Dexmedetomidine, Esmolol, Orthognathic surgery, Controlled hypotension

中图分类号:

R782.05

蒋珏, 林宇, 蒋超. 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[J]. 上海口腔医学, 2021, 30(5): 548-550.

JIANG Jue, LIN Yu, JIANG Chao. Comparison of the effects of dexmedetomidine and esmolol on controlled hypotension in patients with orthognathic surgery[J]. Shanghai Journal of Stomatology, 2021, 30(5): 548-550.

参考文献

[1] Ruku R, Jamwal A, Bhadrala N, et al.Randomized open-Labelled comparative evaluation of the efficacy of nitroglycerine, esmolol and dexmedetomidine in producing controlled hypotension in spine surgeries[J]. Anesth Essays Res, 2019, 13(3): 486-491.
[2] Degoute CS.Controlled hypotension: a guide to drug choice[J].Drugs, 2007, 67(7): 1053-1076.
[3] Jakob SM, Ruokonen E, Grounds RM, et al.Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials[J]. JAMA, 2012, 307(11): 1151-1160.
[4] Shams T, El Bahnasawe NS, Abu-Samra M, et al.Induced hypotension for functional endoscopic sinus surgery: a comparative study of dexmedetomidine versus esmolol[J]. Saudi J Anaesth, 2013, 7(2): 175-180.
[5] Tishchenko AS, Dobrodeev AS.Practical potentials of using dexmedetomidine in oral and maxillofacial surgery[J]. Stomatologiia (Mosk), 2019, 98(6): 131-135.
[6] 张凌, 朱莹. 右美托咪定在口腔颌面外科正颌手术控制性降压中的作用[J]. 中国口腔颌面外科杂志, 2016, 14(1): 62-65.
[7] 梁万益, 梁金华, 陈伟志. 右美托咪定复合瑞芬太尼在择期全麻脊柱手术控制性降压中的应用[J]. 白求恩医学杂志, 2017, 15(1): 22-24.
[8] 郭锐, 郭优勤, 王力峰, 等. 右美托咪定控制性降压在颅内动脉瘤夹毕术中的应用[J]. 广东医学, 2014, 35(15): 2439-2441.
[9] Bajwa SJ, Kaur J, Kulshrestha A, et al.Nitroglycerine, esmolol and dexmedetomidine for induced hypotension during functional endoscopic sinus surgery: a comparative evaluation[J]. J Anaesthesiol Clin Pharmacol, 2016, 32(2): 192-197.
[10] Deng F, Cai L, Zhou B, et al.Whole transcriptome sequencing reveals dexmedetomidine-improves postoperative cognitive dysfunction in rats via modulating lncRNA[J]. Biotech, 2020, 10(5): 202-215.
[11] Chen Q, Wu W, Zhang GC, et al.Dexmedetomidine attenuates hypoxemia during palliative reconstruction of the right ventricular outflow tract in pediatric patients[J]. Medicine (Baltimore), 2014, 93(13): e69-e74.
[12] Bulow NM, Colpo E, Pereira RP, et al.Dexmedetomidine decreases the inflammatory response to myocardial surgery under mini-cardiopulmonary bypass[J]. Braz J Med Biol Res, 2016, 49(4): e4646-e4653.
[13] Afonso J, Reis F.Dexmedetomidine: current role in anesthesia and intensive care[J]. Rev Bras Anestesiol, 2012, 62(1):118-133.

[1]	邵云, 程庆涛, 何欢, 李晶, 朱微燕, 刘嘉靓. 2种不同舒适化技术在60例高血压患者阻生牙拔除术中的应用评价[J]. 上海口腔医学, 2022, 31(1): 109-112.
[2]	邵云, 盛璐, 何欢, 刘慧, 陆萌萌, 祁铭. 右美托咪定结合氟比洛芬酯在局麻下多颗复杂牙拔除术中的应用效果评价[J]. 上海口腔医学, 2021, 30(3): 302-305.
[3]	董翔, 劳蔚, 刘锦星, 纪均. 右美托咪定对口腔颌面外科清醒插管患者吞咽功能的影响[J]. 上海口腔医学, 2021, 30(2): 206-209.
[4]	李莉, 孙健, 李亚莉, 陈立强, 陈晨, 王硕, 王志浩, 孟坤, 孙鸣, 张秀秀. 数字化技术用于25例患者正颌手术效果评价[J]. 上海口腔医学, 2021, 30(2): 219-224.
[5]	孟秋雨, 黄慧敏, 徐辉. 右美托咪定与几种镇静药物在口腔门诊手术中镇静效果的meta分析[J]. 上海口腔医学, 2019, 28(1): 100-109.
[6]	聂萍，陶丽，朱妍菲，孙蕙珺，朱敏. 2种不同正颌术式对骨性Ⅲ类错畸形患者上气道形态的影响[J]. 上海口腔医学, 2018, 27(3): 280-284.
[7]	柴冬冬, 纪均. 右美托咪定复合七氟烷在儿童口腔全麻治疗中的效果评价[J]. 上海口腔医学, 2018, 27(1): 85-88.
[8]	顾鑫宇, 张静露, 吕冬, 陈文静. 骨性Ⅲ类错正畸-正颌联合治疗前后温度感觉功能的定量评价[J]. 上海口腔医学, 2016, 25(5): 583-587.
[9]	应王君子, 沈舜尧, 李彪, 孙昊, 张天嘉, 王旭东. 唇腭裂患者正颌术后上颌骨短期稳定性的三维分析[J]. 上海口腔医学, 2016, 25(3): 345-351.
[10]	刘华, 周驰, 纪均. 不同剂量右美托咪定对腮腺手术患者全麻苏醒质量的影响[J]. 上海口腔医学, 2016, 25(3): 368-372.
[11]	陈佳伟，吕翔，张凌，陈志峰. 瑞芬太尼与右美托咪啶对口腔颌面外科全麻苏醒期的影响[J]. 上海口腔医学, 2016, 25(1): 101-104.
[12]	郭勇,孙璐璐,陈志峰,李启芳,姜虹. 右美托咪定预防老年口腔肿瘤患者术后谵妄的疗效分析[J]. 上海口腔医学, 2015, 24(2): 236-239.
[13]	李星儒,陈立强,李亚莉,孙健. 正颌手术对患者心身症状的影响[J]. 上海口腔医学, 2015, 24(1): 107-110.
[14]	胥杨, 韩向龙, 白丁. 骨性Ⅱ类高角错颌正畸治疗探讨[J]. 上海口腔医学, 2014, 23(4): 508-512.

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

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 14

编辑推荐

Metrics

本文评价