摘要
目的观察清醒插管时不同剂量芬太尼复合咪达唑仑的效果。方法择期气管插管全麻下行巨大甲状腺切除的病人48例,年龄48～58岁,ASA均为Ⅱ级,随机分为单纯表面麻醉组(L),表面麻醉+芬太尼1ug/kg+咪达唑仑40ug/kg(F1)和表面麻醉+芬太尼1.5ug/kg+咪达唑仑40ug/kg(F2组),每组16例。F1和F2静注咪达唑仑40ug/kg,分别静注芬太尼1ug/kg、1.5ug/kg面罩给O2后气管插管,记录麻醉前(T0),暴露声门即刻(T1),插入气管导管即刻(T2)时的MAP、HR及插管过程中有无躁动、呛咳等。结果F2与F1及L比较,插管时F2组对MAP及HR影响明显降低,呛咳、躁动的发生率减少。结论静脉注射芬太尼1.5ug/kg复合咪唑仑40ug/kg,可为巨大甲状腺肿清醒插管提供良好的条件。
Objective To investigate the ef？cacy of different doses of fentanyl combined with midazolam for awake intubation of cacrosis goiter. Methods Elective forty-eight ASA Ⅱ patients of tracheal intubation on anesthesia huge Thyroidectomy, who aged 48～58 years old, were randomly divided into： group received topical anesthesia only （L）; group received midazolam 40 ug/kg and fentanyl 1.0（F1） or 1.5ug/kg（F2）. There were 16 patients in each group.In group F1 and F2 midazolam 40 ug/kg was given, then fentanyl 1.0 or 1.5 ug/kg. Tracheal intubation was performed after oxygen inhalation. MAP,HR and wether restlessness and coughing or not during endotracheal intubation were recorded before anesthesia （T0）, when advanced through vocal cords （T1） and when endotracheal tube was threaded onto trachea （T2）. Results Compared F2 with F1 and L： MAP and HR were obviously reduced during endotracheal intubation. The incidences of restlessness and coughing were lowered. Conclusion Fentanyl 1.5 ug/kg combined with midazolam 40ug/kg given on top of topical anesthesia can provide a good intubation condition with less intubation response.
出处
《当代医学》
2010年第4期128-129,共2页
Contemporary Medicine
