摘要
目的比较不同剂量舒芬太尼在患者清醒状态下胃管置入中的应用效果。方法选取2016年9月—2017年12月在哈尔滨医科大学附属第一医院拟行术前清醒状态下胃管置入的患者90例,按照入院顺序编号并抽签分为A组、B组、C组,每组30例。A组患者静脉注射舒芬太尼(0.100μg/kg)后4 min开始置入胃管;B组患者静脉注射舒芬太尼(0.100μg/kg)后5 min开始置入胃管;C组患者静脉注射舒芬太尼(0.075μg/kg)后5 min开始置入胃管。比较3组患者胃管置入时间,静脉注射舒芬太尼前(T_0)、静脉注射舒芬太尼后2 min(T_1)、静脉注射舒芬太尼后4 min(T_2)、胃管到达咽部时(T_3)、置管后1 min(T_4)、置管后2 min(T_5)平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2)、呼吸频率(RR)、Ramsay镇静评分,置管后疼痛数字评分法(NRS)评分;并观察3组患者置管期间不良反应发生情况。结果 B组患者胃管置入时间短于A组、C组(P<0.05)。时间与方法在MAP、HR、RR及Ramsay镇静评分上无交互作用(P>0.05);时间在MAP、RR及Ramsay镇静评分上主效应不显著(P>0.05);时间在HR上主效应显著(P<0.05);方法在MAP、HR、RR及Ramsay镇静评分上主效应不显著(P>0.05)。3组患者T_0～T_5时SpO_2均>90%,在安全范围内。B组患者置管后NRS评分优于A组(P<0.05)。3组患者置管期间均未发生呕吐、呼吸抑制,B组患者置管期间恶心发生率低于A组(P<0.05)。结论静脉注射舒芬太尼0.100μg/kg或0.075μg/kg均可有效稳定清醒状态下行胃管置入患者的血流动力学,其中静脉注射舒芬太尼0.100μg/kg后5 min开始置入胃管能更有效地缩短置管时间,减轻患者疼痛,降低恶心发生率。
Objective To compare the application effect of different doses of sufentanil in conscious gastric intubation.Methods A total of 90 patients prepared for preoperative conscious gastric intubation were selected in the First Hospital Affiliated to Harbin Medical University from September 2016 to December 2017,and they were divided into A group,B group and C group by draw lots based on admission sequence coding,each of 30 cases.Patients in A group received conscious gastric intubation 4 minutes after intravenous injection of sufentanil(0.100μg/kg),patients in B group received conscious gastric intubation 5 minutes after intravenous injection of sufentanil(0.100μg/kg),while patients in C group received conscious gastric intubation 5 minutes after intravenous injection of sufentanil(0.075μg/kg).Elapsed time of gastric intubation,MAP,heart rate,SpO2,respiratory rate and Ramsay sedation score before intravenous injection of sufentanil(T0),2 minutes after intravenous injection of sufentanil(T1),4 minutes after intravenous injection of sufentanil(T2),when the gastric tube reached pharynx(T3),1 minute after catheterization(T4)and 2 minutes after catheterization(T5),Numeric Rating Scale(NRS)score for pain after catheterization were compared in the three groups,and incidence of adverse reactions during catheterization was observed.Results Elapsed time of gastric intubation in B group was statistically significantly shorter than that in A group and C group,respectively(P<0.05).No statistically significant differences of interaction was found in MAP,heart rate,respiratory rate or Ramsay sedation score between time and method(P>0.05);main effect of time was not statistically significant in MAP,respiratory rate or Ramsay sedation score(P>0.05),while main effect of time was statistically significant in heart rate(P<0.05);main effect of method was not statistically significant in MAP,heart rate,respiratory rate or Ramsay sedation score(P>0.05).SpO2 in the three group was over 90%from T0 to T5,respectively,which was in the refere
作者
魏绍婷
许占宏
WEI Shaoting;XU Zhan-hong(Department of Anesthesiology,the First Hospital Affiliated to Harbin Medical University,Harbin 150081,China)
出处
《实用心脑肺血管病杂志》
2018年第7期74-77,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
插管法
胃肠
舒芬太尼
疗效比较研究
Intubation,gastrointestinal
Sufentanil
Comparative effectiveness research
