摘要
目的 评价右美托咪啶用于困难气道患者经帝视内镜引导清醒气管插管术的效果。方法 选取已预料的困难气道患者60例,采用随机数字表法将其分为表面麻醉+右美托咪啶组+瑞芬太尼组(D组,n=30)、表面麻醉+咪达唑伦组+瑞芬太尼组(M组,n=30)。咽喉壁及声门表面麻醉后,D组静脉泵注右美托咪啶1μg/kg,泵注10 min;M组静脉输注咪达唑伦0.03 mg/kg,两组患者气管插管前静脉注射瑞芬太尼0.5μg/kg。记录患者入室(T0)、气管插管前(T1)、气管插管时(T2)及气管插管后5 min(T3)时间点生命体征及BIS值;记录T2时患者体动、呛咳等耐受情况,呼吸抑制发生率及术后不良记忆的发生情况。结果与D组相比,M组气管插管时体动、呛咳发生率明显升高(P<0.05);与M组比较,D组在T2时间点平均动脉压、心率及BIS值明显降低(P<0.05),T3时间点平均动脉压及BIS值明显降低(P<0.05);无术后不良记忆发生。结论 咽喉壁表面麻醉下,右美托咪啶复合瑞芬太尼能够提供较好的清醒气管插管条件,且不良反应率低。
Objective To evaluate the effect of dexmedetomidine for awake endoscopic intubation in patients with difficult airways.Method Sixty patients with expected difficult airway were selected and divided into topical anesthesia+dexmedetomidine+remifentanil group(group D,n=30),topical anesthesia+midazolam+ remifentanil group(group M,n=30).After the throat and glottis were surface anesthetized,group D received intravenous pump injection of dexmedetomidine 1 μg/kg for 10 minutes;group M received intravenous midazolam 0.03 mg/kg,and the two groups were intravenous before tracheal intubation remifentanil was injected 0.5 μg/kg.Record the patient’s vital signs and BIS values at the time of entry(T0),before tracheal intubation(T1),during tracheal intubation(T2),and 5 min after tracheal intubation(T3);record patient movement,coughing,etc.at T2 Tolerance,incidence of respiratory depression and incidence of postoperative bad memory.Results Compared with group D,the incidence of body movement and coughing during tracheal intubation in group M was significantly increased(P<0.05);compared with group M,the average arterial pressure,heart rate and BIS value of group D at T2 were significantly lower(P<0.05),the mean arterial pressure and BIS value at T3 time point were significantly reduced(P<0.05);no postoperative bad memory occurred.Conclusion Under surface anesthesia of the throat,dexmedetomidine combined with remifentanil can provide better conditions for awake tracheal intubation,and the adverse reaction rate is low.
作者
丛姗
苏日娜
CONG Shan;SU RI NA(Chifeng Clinical Medical College,Inner Mongolia Medical University,Chifeng 024000 China)
出处
《内蒙古医学杂志》
2022年第2期175-177,共3页
Inner Mongolia Medical Journal
关键词
右美托咪啶
帝视内窥镜
气管插管
dexmedetomidine
disposcope endoscope
tracheal intubation
