右美托咪定联合肿胀麻醉在美容整形手术中的应用

曾亮

[摘 要]目的 分析在美容整形手术中应用右美托咪定联合肿胀麻醉的效果。方法 选取2022年11月-2023年11月我院收治的106例行美容整形手术患者作为研究对象，随机分为参照组和试验组，各53例。参照组应用丙泊酚联合肿胀麻醉，试验组应用右美托咪定联合肿胀麻醉，比较两组生命体征指标及临床指标。结果两组T1时MAP、RR、HR水平均低于T0时，且试验组T2和T3时MAP、HR均低于参照组，RR高于参照组（P<0.05）；试验组舒芬太尼用量少于参照组，VAS评分、体动或疼痛、呼吸抑制发生率低于参照组，清醒时间短于参照组（P<0.05）。结论 在美容整形手术过程中应用右美托咪定联合肿胀麻醉能更好的稳定患者血流动力学、减少舒芬太尼用量，提高麻醉效果和安全性，值得临床应用。

[关键词] 右美托咪定；肿胀麻醉；美容整形手术

[中图分类号] R622 [文献标识码] A [文章编号] 1004-4949（2024）05-0159-04

Application of Dexmedetomidine Combined with Tumescent Anesthesia in Cosmetic Plastic Surgery

ZENG Liang

（Department of Anesthesiology， Nanchong Central Hospital， Nanchong 637000， Sichuan， China）

[Abstract]Objective To analyze the effect of dexmedetomidine combined with tumescent anesthesia in cosmetic plastic surgery. Methods A total of 106 patients undergoing cosmetic plastic surgery admitted to our hospital from November 2022 to November 2023 were randomly divided into reference group and experimental group， with 53 patients in each group. The reference group was treated with propofol combined with tumescent anesthesia， and the experimental group was treated with dexmedetomidine combined with tumescent anesthesia. The vital signs and clinical indicators of the two groups were compared. Results The MAP， RR and HR levels of the two groups at T1 were lower than those at T0， and the MAP and HR of the experimental group at T2 and T3 were lower than those of the reference group， and the RR was higher than that of the reference group （P<0.05）. The dosage of sufentanil in the experimental group was less than that in the reference group， the VAS score， the incidence of body movement or pain and respiratory depression were lower than those in the reference group， and the awake time was shorter than that in the reference group （P<0.05）. Conclusion The application of dexmedetomidine combined with tumescent anesthesia can better stabilize the hemodynamics for patients in cosmetic plastic surgery， reduce the dosage of sufentanil， improve the anesthetic effect and safety， and is worthy of clinical application.

[Key words] Dexmetomidine； Tumescent anesthesia； Cosmetic plastic surgery

當今社会背景下，人们提高了对美的追求，促使美容整形行业快速发展，而隆乳、隆鼻、除皱、抽脂等手术是速度快且效果好的整形美容方式[1]。无论哪种手术均需要合理选择麻醉方案，才能保证手术顺利进行。肿胀麻醉联合静脉麻醉为临床麻醉的主要方式，既往常使用丙泊酚、舒芬太尼，具有起效快速等优势，但是会影响患者的血流动力学、呼吸系统等，而右美托咪定有着良好的镇静效果，已广泛应用于临床[2]。为了确定最佳的麻醉方案，本研究旨在分析右美托咪定联合肿胀麻醉在美容整形手术中的效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2022年11月-2023年11月南充市中心医院收治的106例行美容整形手术的患者，随机分为参照组和试验组，各53例。参照组男2例，女51例；年龄20～55岁，平均年龄（36.74±2.48）岁；手术类型：面部自体脂肪填充术7例、隆鼻术6例、隆乳术8例、腹部抽脂术32例。试验组男4例，女49例；年龄19～53岁，平均年龄（36.15±2.19）岁；手术类型：面部自体脂肪填充术8例、隆鼻术5例、隆乳术6例、腹部抽脂术34例。……