中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2010年
12期
1435-1436
,共2页
邵雪泉%潘中心%兰允平%徐玲%占霖森%杨淑芬%余功敏%黄莉%郑丽花%吴方璞
邵雪泉%潘中心%蘭允平%徐玲%佔霖森%楊淑芬%餘功敏%黃莉%鄭麗花%吳方璞
소설천%반중심%란윤평%서령%점림삼%양숙분%여공민%황리%정려화%오방박
麻醉药,吸入%咪达唑仑%哌啶类%插管法,气管内%颈部制动
痳醉藥,吸入%咪達唑崙%哌啶類%插管法,氣管內%頸部製動
마취약,흡입%미체서륜%고정류%삽관법,기관내%경부제동
Anesthetics,inhalation%Midazolam%Piperdines%Intubation,intratracheal%Neck brake
目的 评价七氟醚-咪达唑仑-瑞芬太尼麻醉诱导用于颈部制动患者无肌松药气管插管的可行性.方法 颈椎骨折伴脱位拟在全麻下手术患者40例,年龄13～68岁,ASA分级Ⅰ～Ⅲ级.静脉注射咪达唑仑0.03 mg/kg,面罩吸入5%七氟醚,每30 s递减1%,直至3%.待患者睫毛反射消失时,45 s内缓慢静脉注射瑞芬太尼2μg/kg,30 s后停止吸入七氟醚,气管插管后行机械通气.记录睫毛反射消失时间,采用Viby-Mogensen评分法评价气管插管条件.结果 睫毛反射消失时间(69±4)s,一次气管插管成功率为100%,喉镜置入顺利,声门暴露基本良好.3例患者气管插管时出现轻微呛咳.气管插管条件优良率100%.所有患者SpO2均＞95%,气管插管前至气管插管后3 min BIS值40～55.结论 七氟醚-咪达唑仑-瑞芬太尼麻醉诱导迅速而平稳,可提供良好的气管插管条件,适用于颈部制动患者无肌松药气管插管,安全可行.
目的 評價七氟醚-咪達唑崙-瑞芬太尼痳醉誘導用于頸部製動患者無肌鬆藥氣管插管的可行性.方法 頸椎骨摺伴脫位擬在全痳下手術患者40例,年齡13～68歲,ASA分級Ⅰ～Ⅲ級.靜脈註射咪達唑崙0.03 mg/kg,麵罩吸入5%七氟醚,每30 s遞減1%,直至3%.待患者睫毛反射消失時,45 s內緩慢靜脈註射瑞芬太尼2μg/kg,30 s後停止吸入七氟醚,氣管插管後行機械通氣.記錄睫毛反射消失時間,採用Viby-Mogensen評分法評價氣管插管條件.結果 睫毛反射消失時間(69±4)s,一次氣管插管成功率為100%,喉鏡置入順利,聲門暴露基本良好.3例患者氣管插管時齣現輕微嗆咳.氣管插管條件優良率100%.所有患者SpO2均＞95%,氣管插管前至氣管插管後3 min BIS值40～55.結論 七氟醚-咪達唑崙-瑞芬太尼痳醉誘導迅速而平穩,可提供良好的氣管插管條件,適用于頸部製動患者無肌鬆藥氣管插管,安全可行.
목적 평개칠불미-미체서륜-서분태니마취유도용우경부제동환자무기송약기관삽관적가행성.방법 경추골절반탈위의재전마하수술환자40례,년령13～68세,ASA분급Ⅰ～Ⅲ급.정맥주사미체서륜0.03 mg/kg,면조흡입5%칠불미,매30 s체감1%,직지3%.대환자첩모반사소실시,45 s내완만정맥주사서분태니2μg/kg,30 s후정지흡입칠불미,기관삽관후행궤계통기.기록첩모반사소실시간,채용Viby-Mogensen평분법평개기관삽관조건.결과 첩모반사소실시간(69±4)s,일차기관삽관성공솔위100%,후경치입순리,성문폭로기본량호.3례환자기관삽관시출현경미창해.기관삽관조건우량솔100%.소유환자SpO2균＞95%,기관삽관전지기관삽관후3 min BIS치40～55.결론 칠불미-미체서륜-서분태니마취유도신속이평은,가제공량호적기관삽관조건,괄용우경부제동환자무기송약기관삽관,안전가행.
Objective To evaluate the feasibility of induction with sevoflurane-midazolam-remifentail for tracheal intubation without muscle relaxants in neck brake patients.Methods Forty ASA Ⅰ or Ⅱ patients with cervical spine fracture with dislocation,aged 13-68 yr,scheduled for surgery under general anesthesia,were enrolled in this study.Anesthesia was induced with iv injection of midazolam 0.03 mg/kg and inhalation of 5%sevoflurane through a mask.Sevoflurane was inhaled at the initial concentration of 5%,followed by decrement of 1% every 30 s until 3%.When the eyelash reflex disappeared,remifentanil 2 μg/kg was injected slowly over 45s and 30 s later sevoflurane inhalation was stopped.The patients were mechanically ventilated after tracheal intubation.The time of disappearance of eyelash reflex was recorded.The intubation condition was evaluated using VibyMogensen score.Results All patients were successfully intubated at the first attempt.The time period from sevoflurane inhalation to disappearance of eyslash reflex was(69 ± 4)s.Coughing occurred in 3 cases during intubation.The satisfactory intubation conditions were found in 100% of cases.SpO2 ＞ 95% in all patients.BlS was maintained at 45-55 during the period(before intubation until 3 min after intubation).Conclusion Induction with sevoflurane-midazolam-remifentail is rapid and smooth,provides good conditions for intubation and can be applied to tracheal intubation without muscle relaxants in neck brake patients.
