背景:本研究旨在探讨七氟烷联合瑞芬太尼的有效性,艾司洛尔,或硝酸甘油用于降压麻醉,并确定适合正颌手术的降压麻醉方法。
方法:这项回顾性研究纳入了60例因发育性错牙合而接受正颌手术的患者。根据降压药物的偏好将他们分为三组:第1组(n=20),七氟醚和瑞芬太尼;第2组(n=20),七氟醚和艾司洛尔;第3组(n=20),七氟醚和硝酸甘油.出血量,心率,收缩压,舒张压,在围手术期的某些时间记录平均动脉血压,包括在身体压力水平增加的阶段,如切口和截骨术。病人的血压,记录术后镇痛消耗和疼痛水平.
结果:出血量,与出血相关的手术满意度,两组总手术时间无显著差异。术中,第3组的心率显著高于第1组和第2组(p=0.001).然而,第1组和第2组的血流动力学稳定性相似.术后,镇痛消耗,疼痛程度,两组间血压动力学无显著差异(p>0.05)。
结论:根据本研究的结果,结论是输注瑞芬太尼,艾司洛尔,或硝酸甘油联合七氟醚在正颌手术中成功实现了靶向性降压麻醉,可作为替代方法。使用哪种方法的决定应考虑患者的总体健康状况和其他医疗条件。
BACKGROUND: This study aimed to investigate the effectiveness of combining sevoflurane with remifentanil, esmolol, or nitroglycerin for hypotensive anesthesia and determine the suitable hypotensive anesthesia method for orthognathic surgery.
METHODS: This retrospective study included 60 patients who underwent orthognathic surgery for developmental malocclusion. They were divided into three groups based on the hypotensive agent preferences: Group 1 (n = 20), sevoflurane and remifentanil; Group 2 (n = 20), sevoflurane and esmolol; Group 3 (n = 20), sevoflurane and nitroglycerin. Bleeding volume, heart rate, systolic, diastolic, and mean arterial blood pressure were recorded at certain times during the perioperative period, including at stages with increased stress levels in the body, such as incision and osteotomy. The patients\' blood pressure, analgesic consumption and pain level were recorded in the postoperative period.
RESULTS: Bleeding volume, surgery satisfaction related to bleeding, and total operation time did not differ significantly between groups. Intraoperatively, heart rates were significantly higher in Group 3 than in Groups 1 and 2 (p = 0.001). However, hemodynamic stability was similar in Groups 1 and 2. Postoperatively, analgesic consumption, pain levels, and blood pressure dynamics did not differ significantly between groups (p > 0.05).
CONCLUSIONS: Based on this study\'s results, it was concluded that infusing remifentanil, esmolol, or nitroglycerin with sevoflurane during orthognathic surgery successfully achieved the targeted hypotensive anesthesia and can be considered alternative methods. The decision on which method to use should consider the patient\'s overall health status and additional medical conditions.