摘要
目的研究丙泊酚复合瑞芬太尼用于患者清醒状态下实施气管插管的可行性,以及插管过程中,插管操作对血压、心率等生命体征的影响。方法选取2012年12月-2013年4月美国麻醉医师协会分级Ⅰ～Ⅱ级、施行全身麻醉手术患者80例,将其随机分为两组。A组为芬太尼丙泊酚组;B组为瑞芬太尼-丙泊酚-利多卡因组;两组患者性别、年龄、体质量等一般资料比较差异无统计学意义（P〉0.05）。A组患者采用常规诱导插管方法：给予咪达唑仑0.05～0.10 mg/kg,芬太尼4μg/kg,丙泊酚1.0～1.5 mg/kg,阿曲库铵0.6～0.9 mg/kg,肌肉松弛后行气管插管。B组患者采用瑞芬太尼-丙泊酚-利多卡因复合液缓慢静脉泵注,复合环甲膜穿刺的方法行气管插管。观察两组患者诱导前后生命体征变化和呛咳反应发生情况。结果两组患者均能顺利完成气管插管,A组患者循环改变以及心动过速的发生率明显高于B组（P〈0.05）。两组患者心动过缓、低氧血症及呛咳反应发生率均低,差异无统计学意义（P〉0.05）。结论瑞芬太尼-丙泊酚-利多卡因复合液能够安全用于患者清醒状态下实施气管插管,血流动力学稳定,具有临床推广价值。
Objective To study the feasibility of using propofol and remifentanil for tracheal intubation in patients who are awake, and investigate the infl uence of tracheal intubation on such vital signs as blood pressure and heart rates. Methods Eighty ASA I-II patients who underwent general anesthesia in our hospital between December 2012 and April 2013 were randomly divided into two groups. Patients in group A received fentanyl-propofol, while patients in group B received remifentanyl-propofol-lidocaine. There was no signifi cant difference between the two groups in gender, age, and body weight（P 〉0.05）. Conventional intubation induction method was used for group A： 0.05-0.10 mg/kg midazolam, 4 μg/kg fentanyl, 1.0-1.5 mg/kg propofol, and 0.6-0.9 mg/kg atracurium were given and tracheal intubation was performed after muscle relaxation. Group B patients were treated with remifentanyl propofol-lidocaine compound liquid slow intravenous injection, and compound cricothyroid membrane puncture method before endotracheal intubation. We observed the two groups of patients for vital signs before and after induction, and choking cough reactions. Results Patients in both the two groups were all able to complete tracheal intubation. Circulation change and incidence of tachycardia in patients of group A were signifi cantly higher than those in group B（P 〈0.05）. The rates of bradycardia, hypoxemia, and choking cough response were low in both groups with no statistically signifi cant difference（P〉 0.05）. Conclusion Remifentanyl propofol-lidocaine compound liquid can be safely used for implementation of endotracheal intubation in patients who are awake, and the hemodynamic stability can be maintained.
出处
《华西医学》
CAS
2014年第10期1887-1890,共4页
West China Medical Journal
关键词
瑞芬太尼
气管插管
丙泊酚
清醒
利多卡因
Remifentanyl
Endotracheal intubation
Propofol
Awake
Lidocaine
