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正颌外科手术中的术中失血:瑞芬太尼麻醉与七氟醚或异氟醚麻醉的比较

Intraoperative Blood Loss During Orthognathic Surgery: A Comparison of Remifentanil-Based Anesthesia With Sevoflurane or Isoflurane.

作者信息

Wakasugi Yumiko, Matsuura Nobuyuki, Ichinohe Tatsuya

机构信息

Postgraduate Student, Department of Dental Anesthesiology, Tokyo Dental College, Chiba, Japan.

Senior Assistant Professor, Department of Dental Anesthesiology, Tokyo Dental College, Chiba, Japan.

出版信息

J Oral Maxillofac Surg. 2015 Dec;73(12):2294-9. doi: 10.1016/j.joms.2015.03.076. Epub 2015 Apr 14.

Abstract

PURPOSE

The aim of the present study was to compare the blood loss with remifentanil-based anesthesia with sevoflurane or isoflurane during orthognathic surgery.

PATIENTS AND METHODS

In this randomized controlled clinical trial, the patients who were scheduled for orthognathic surgery were divided into 2 groups: the sevoflurane (Sevo) group and isoflurane (Iso) group. Anesthesia was maintained using end-tidal concentrations of 1.4% sevoflurane or 0.9% isoflurane. Remifentanil was continuously infused at 0.05 to 0.5 μg/kg/min to maintain the mean blood pressure (MBP) at 60 to 65 mm Hg. The intraoperative blood loss was compared between the 2 groups. The Student t test for unpaired samples was used for statistical analysis. P < .05 was considered statistically significant.

RESULTS

The study sample included 19 men and 45 women (n = 64). The mean age was 25 years (range 16 to 50). The intraoperative blood loss tended to be greater in the Iso group (n = 32; 4.79 ± 3.22 mL/kg) than in the Sevo group (n = 32; 4.00 ± 1.98 mL/kg). However, the difference between the 2 groups was not significant.

CONCLUSION

In a comparison of intraoperative blood loss during remifentanil-based anesthesia with sevoflurane or isoflurane during orthognathic surgery, no difference was observed between the 2 groups.

摘要

目的

本研究旨在比较正颌手术中瑞芬太尼复合七氟醚或异氟醚麻醉的失血量。

患者与方法

在这项随机对照临床试验中,计划进行正颌手术的患者被分为两组:七氟醚(Sevo)组和异氟醚(Iso)组。采用呼气末浓度为1.4%的七氟醚或0.9%的异氟醚维持麻醉。瑞芬太尼以0.05至0.5μg/kg/min的速度持续输注,以维持平均血压(MBP)在60至65mmHg。比较两组术中失血量。采用成组t检验进行统计学分析。P <.05被认为具有统计学意义。

结果

研究样本包括19名男性和45名女性(n = 64)。平均年龄为25岁(范围16至50岁)。异氟醚组(n = 32;4.79±3.22mL/kg)术中失血量往往高于七氟醚组(n = 32;4.00±1.98mL/kg)。然而,两组之间的差异无统计学意义。

结论

在正颌手术中,比较瑞芬太尼复合七氟醚或异氟醚麻醉的术中失血量,两组之间未观察到差异。

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