摘要
目的：比较不同剂量右美托咪定联合七氟烷在肥胖困难气道患者保留自主呼吸插管中的应用效果。方法选取2014年5月～2015年5月本院收治的40例肥胖困难气道患者作为研究对象，随机分为a、b、c、d组，各10例。a组采用清醒气管插管，b组给予右美托咪定0.6μg/kg联合七氟烷气管插管，c组给予右美托咪定1.0μg/kg联合七氟烷，d组给予右美托咪定1.2μg/kg联合七氟烷气管插管。比较4组麻醉插管前（T0）、插管即刻（T1）、插管后3 min（T2）、插管后5 min（T3）的收缩压（SBP）、舒张压（DBP）、心率（HR）、呛咳评分以及插管过程中的不良事件发生率。结果4组T0时的SBP、DBP、HR水平比较，差异无统计学意义（P〉0.05）。 a组和b组T1、T2、T3时的SBP、DBP、HR水平比较，差异无统计学意义（P〉0.05）。 c组和d组T1、T2、T3时的SBP、DBP、HR水平显著低于a组和b组，差异有统计学意义（P〈0.05）。 c组和d组插管期间的呛咳评分显著低于a组和b组，差异有统计学意义（P〈0.05）。b、c、d组术后5 min的OAA/S镇静评分显著低于a组，差异有统计学意义（P〈0.05）。b、c、d组术后5 min的OAA/S镇静评分比较，差异无统计学意义（P〉0.05）。4组术后10、15 min的OAA/S镇静评分比较，差异无统计学意义（P〉0.05）。结论静脉输注1.0、1.2μg/kg右美托咪定与七氟烷联合应用于保留呼吸全身麻醉插管可以有效抑制全身麻醉插管期的心血管反应并减少插管呛咳等副反应，但1.0μg/kg右美托咪定的副作用小，安全性更大，同时不影响全身麻醉拔管及苏醒时间。
Objective To compare the application effect of different doses of dexmedetomidine combined with sevoflu-rane in trachea cannula for maintaining autonomous respiration due to difficult airway in obese patients. Methods 40 obese Patients with difficult airway from May 2014 to May 2015 were selected and randomly divided into group a,group b,group c and group d,10 cases in each group.Geoup a was given tracheal intubation on awakening,group b was given tracheal intubation by 0.6 μg/kg dexmedetomidine combined with sevoflurane,group c was given tracheal intubation by 1.0 μg/kg dexmedetomidine combined with sevoflurane,tracheal intubation by 1.2 μg/kg dexmedetomidine combined with sevoflurane.Systolic blood pressure （SBP）,diastolic blood pressure （DBP）,heart rate （HR） and score of bucking in prior intubation before anesthesia （T0）,instant intubation （T1）,3 minutes after intubation （T2）,and 5 minutes after intuba-tion （T3）,the occurrence rate of adverse event during intubation among four groups was compared. Results There was no significant difference in the level of systolic blood pressure （SBP）,diastolic blood pressure （DBP） and HR at T0 among four groups （P〉0.05）.There was no significant difference in the level of SBP,DBP and HR during T1,T2 and T3 between group a and group b （P〉0.05）.The level of SBP,DBP and HR during T1,T2 and T3 in group c and group d was lower than that in group a and group b,with significant difference （P〈0.05）.The score of bucking in prior intubation in group c and group d was lower than that in group a and group b,with significant difference （P〈0.05）.The OAA/S sedation score after operation at 5 min in group b,group c and group d was lower than that in group a,with significant difference （P〈0.05）. There was no significant difference in the OAA/S sedation score after operation at 5 min among group b,group c and group d （P〉0.05）.There was no significant difference in the OAA/S sedation score after operation at 10,15 min am
出处
《中国当代医药》
2015年第29期119-122,125,共5页
China Modern Medicine
基金
吉林省吉林市科技计划项目(201437099)
关键词
肥胖
困难气道
右美托咪定
七氟烷
Obesity
Difficult airway
Dexmedetomidine
Sevoflurane
