Efficacy of intraoperative dexmedetomidine infusion on visualization of the surgical field in endoscopic sinus surgery.
Efficacy of intraoperative dexmedetomidine infusion on visualization of the surgical field in endoscopic sinus surgery.
复制标题
术中右美托咪定输注对内窥镜鼻窦手术中手术场的可视化功效。
DOI：
10.4097/kjae.2015.68.5.449
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发表时间：
2015-10
影响因子：
2.9
通讯作者：
Choi SH
中科院分区：
文献类型：
--
作者：
Kim H;Ha SH;Kim CH;Lee SH;Choi SH
在内窥镜鼻窦手术中，手术野的可视化是一个主要问题，因为手术出血是许多并发症的原因。本研究的目的是比较右美托咪定和瑞芬太尼对鼻内窥镜手术术野可视化的影响。前瞻性入组43例患者，随机分配至右美托咪定或瑞芬太尼组，使用丙泊酚靶控输注诱导和维持全身麻醉。右美托咪定组给予右美托咪定负荷5 min，持续输注。瑞芬太尼组采用瑞芬太尼靶控输注。手术完成后，采用数字评分量表评估术野可视化的满意度，评分范围为0（=最差）至10（=最佳）。记录平均血压、心率、恢复情况和术后疼痛评分。两组之间通过数字评定量表获得的可视化满意度评分无显著差异（P = 0.95）。平均血压和心率无差异。右美托咪定组拔管时间（8.4 ± 1.8 min）明显短于瑞芬太尼组（11.9 ± 5.4 min）（P = 0.04）。除拔管时间外，两组的恢复情况相当。在接受内窥镜鼻窦手术的患者中，右美托咪定的连续输注提供了与瑞芬太尼靶控输注相似的术野可视化和血流动力学稳定性。
In endoscopic sinus surgery, visualization of the surgical field is a major concern, as surgical bleeding is the cause of many complications. The purpose of this study was to compare the effects of dexmedetomidine and remifentanil on the visualization of the surgical field in endoscopic sinus surgery. Forty-three patients were prospectively enrolled and randomly allocated to the dexmedetomidine or remifentanil group and general anesthesia was induced and maintained using a propofol target-controlled infusion. In the dexmedetomidine group, dexmedetomidine was loaded for 5 min and a continuous infusion was administered. In the remifentanil group, a remifentanil target-controlled infusion was used. After completion of the operation, the satisfaction with the visualization of the surgical field was assessed on a numeric rating scale, from 0 (= worst) to 10 (= best). The mean blood pressure, heart rate, recovery profiles, and postoperative pain score were recorded. Satisfaction score for visualization by numeric rating scale was not significantly different between the two groups (P = 0.95). There were no differences in the mean blood pressure and heart rate. The extubation time was significantly shorter in the dexmedetomidine group (8.4 ± 1.8 min) than in the remifentanil group (11.9 ± 5.4 min) (P = 0.04). Except for the extubation time, the recovery profiles of the two groups were comparable. Continuous infusions of dexmedetomidine provide a similar visualization of the surgical field and hemodynamic stability as remifentanil target-controlled infusions in patients undergoing endoscopic sinus surgery.