摘要
目的比较七氟烷或丙泊酚伍用舒芬太尼靶控输注诱导用于纤维支气管镜引导下无肌松气管插管的临床效果。方法 60例行择期手术的全麻患者,ASAⅠ-Ⅱ级,随机分为七氟烷组(S组)及丙泊酚组(P)组,均靶控输注舒芬太尼,在纤维支气管镜引导下经口气管插管。记录患者入室后(T0)、诱导前(T1)、诱导后(T2)、插管后即刻(T3)、插管后1 min(T4)、插管后2 min(T5)的血压(MAP)、心率(HR)、脉搏氧饱和度(Sp O2);诱导前(T1)、诱导后(T2)、插管后(T3)TOF值;记录意识消失、诱导及插管时间;进镜及插管深度,诱导后OAA/S评分;记录插管及术后24 h时不良反应发生率。结果两组间比较,P组MAP在T2较S组降低,HR在T2、T3、T4、T5较S组升高,意识消失和诱导时间较S组长,给麻黄碱例数较S组多(P<0.05);两组的MAP、HR在其余各时点差异无统计学意义,两组间插管时间、进镜及插管深度、给阿托品例数、TOF值、诱导后OAA/S评分、不良反应发生率差异均无统计学意义(P>0.05)。与T1比较,P组MAP在T2、T3降低,HR在T3升高;S组MAP在T2、T3降低,HR在T2升高(P<0.05),其余各时点差异无统计学意义。结论七氟烷与丙泊酚伍用舒芬太尼诱导均可安全用于全麻患者无肌松气管插管,为操作者提供较好的插管条件。
Objective To compare the clinical effect of sevoflurane or propofol combined with targeted controlled infusion （TCI） of sufentanil in patients undergoing endotracheal intubation without muscle relaxants using brenchofiberscope. Methods Sixty ASA I - Ⅱ patients undergoing selective operations under general anesthesia were randomized into two groups （ n = 30 ） ： sevoflurane group and propofol group. Patients in two groups received TCI of sufentainl combined with sevoflurane or propofol respectively and then endotra- eheal intubation under the guidance of bronehofiberscope. The mean arterial pressure（ MAP）, heart rate（HR） and pulse oxygen satura- tion （ SpO2 ） were monitored when patients entering operation room （To ）, before induction （ Tl ）, after induction （T2 ）, immediate after intubation（ T3 ）, at 1 min after intubation（ T4 ）, 2 min after intubation（ T5 ）. The TOF was recorded before induction, after induction and after intubation. The time of consciousness loss, induction and intubation, the depths of bronehofiberscope and endotracheal intu- bation and the Observer＇ s Assessment of Alertness/Sedation Scale（OAA/S） were recorded. The incidences of adverse reactions during induction and at 24 h after operation were also recorded. Results MAP in propofol group was significantly lower than that in sevoflu- rane group at T2. HR at T2, T3, T4, T5 in propofol group were higher than those in sevoflurane group. The time of loss and induction was longer in propofol group than those in sevoflurane group, and the case numbers of needing ephedrine in propofol group were more than that in sevoflurane group（P 〈 0.05 ）. MAP and HR at the other time points, intubation time, depth of brenchofi- berseope and endotracheal intubation, the case numbers of needing atropine, TOF, OAA/S after intubation and the incidence of ad- verse effects showed no statistical difference between two groups （ P 〉 0.05 ）. Compared with T1 , MAP were decreased in propofol group at T2, T3
出处
《山西医科大学学报》
CAS
2015年第6期597-601,共5页
Journal of Shanxi Medical University
关键词
无肌松气管插管
纤维支气管镜
舒芬太尼
七氟烷
丙泊酚
endotracheal intubation without muscle relaxant
bronchofiberscope
sufentanil
sevoflurane
propofol
