中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2014年
19期
72-74
,共3页
王蕾%贾一帆%黄光胜%徐勇
王蕾%賈一帆%黃光勝%徐勇
왕뢰%가일범%황광성%서용
地佐辛%表面麻醉%饱胃%清醒插管
地佐辛%錶麵痳醉%飽胃%清醒插管
지좌신%표면마취%포위%청성삽관
Dezocine%Surface anesthesia%Food intaken%Awake intubation
目的：探讨地佐辛联合表面麻醉用于急诊饱胃患者清醒气管插管的效果。方法将ASAI、Ⅱ级40例需行清醒气管插管的患者随机分为两组,每组20例。A组患者入室后给予0.15 mg/kg的1 mg/mL地佐辛静注,B组患者静脉给生理盐水0.15 mL/kg,5 min后两组分别行口咽喉腔表面麻醉及环甲膜穿刺气管内表面麻醉,再行清醒气管插管,记录进入手术室时(T1)、环甲膜穿刺气管内表面麻醉时(T2)、插管中(T3)、插管后(T4)的平均动脉压(MAP)、心率(HR)。记录从表面麻醉到气管内插管成功的诱导时间。统计并分析T2、T3时点患者躁动、恶心、呛咳的发生率。结果两组患者一般情况无明显差异,在T2、T3、T4时点,B组患者MAP明显高于A组,B组HR也明显快于A组,差异有统计学意义(P<0.05)；B组诱导时间[(8.7±2.7)min]明显长于A组[(5.3±1.2)min],B组各时点的体动评分[T2：(1.2±0.7)分、T3：(1.8±0.5)分]均高于A组[T2：(0.4±0.3)分、T3：(0.6±0.4)分],B组恶心、呛咳发生率(85%)高于A组(30%),两组比较差异有统计学意义(P<0.05),B组有3例患者无法耐受放弃清醒插管,改用快速诱导全麻插管。结论地佐辛联合表面麻醉用于饱胃清醒气管插管,可一定程度上提高患者清醒插管的舒适度,同时清醒插管患者的血流动力学更加稳定,具有一定的临床应用价值。
目的：探討地佐辛聯閤錶麵痳醉用于急診飽胃患者清醒氣管插管的效果。方法將ASAI、Ⅱ級40例需行清醒氣管插管的患者隨機分為兩組,每組20例。A組患者入室後給予0.15 mg/kg的1 mg/mL地佐辛靜註,B組患者靜脈給生理鹽水0.15 mL/kg,5 min後兩組分彆行口嚥喉腔錶麵痳醉及環甲膜穿刺氣管內錶麵痳醉,再行清醒氣管插管,記錄進入手術室時(T1)、環甲膜穿刺氣管內錶麵痳醉時(T2)、插管中(T3)、插管後(T4)的平均動脈壓(MAP)、心率(HR)。記錄從錶麵痳醉到氣管內插管成功的誘導時間。統計併分析T2、T3時點患者躁動、噁心、嗆咳的髮生率。結果兩組患者一般情況無明顯差異,在T2、T3、T4時點,B組患者MAP明顯高于A組,B組HR也明顯快于A組,差異有統計學意義(P<0.05)；B組誘導時間[(8.7±2.7)min]明顯長于A組[(5.3±1.2)min],B組各時點的體動評分[T2：(1.2±0.7)分、T3：(1.8±0.5)分]均高于A組[T2：(0.4±0.3)分、T3：(0.6±0.4)分],B組噁心、嗆咳髮生率(85%)高于A組(30%),兩組比較差異有統計學意義(P<0.05),B組有3例患者無法耐受放棄清醒插管,改用快速誘導全痳插管。結論地佐辛聯閤錶麵痳醉用于飽胃清醒氣管插管,可一定程度上提高患者清醒插管的舒適度,同時清醒插管患者的血流動力學更加穩定,具有一定的臨床應用價值。
목적：탐토지좌신연합표면마취용우급진포위환자청성기관삽관적효과。방법장ASAI、Ⅱ급40례수행청성기관삽관적환자수궤분위량조,매조20례。A조환자입실후급여0.15 mg/kg적1 mg/mL지좌신정주,B조환자정맥급생리염수0.15 mL/kg,5 min후량조분별행구인후강표면마취급배갑막천자기관내표면마취,재행청성기관삽관,기록진입수술실시(T1)、배갑막천자기관내표면마취시(T2)、삽관중(T3)、삽관후(T4)적평균동맥압(MAP)、심솔(HR)。기록종표면마취도기관내삽관성공적유도시간。통계병분석T2、T3시점환자조동、악심、창해적발생솔。결과량조환자일반정황무명현차이,재T2、T3、T4시점,B조환자MAP명현고우A조,B조HR야명현쾌우A조,차이유통계학의의(P<0.05)；B조유도시간[(8.7±2.7)min]명현장우A조[(5.3±1.2)min],B조각시점적체동평분[T2：(1.2±0.7)분、T3：(1.8±0.5)분]균고우A조[T2：(0.4±0.3)분、T3：(0.6±0.4)분],B조악심、창해발생솔(85%)고우A조(30%),량조비교차이유통계학의의(P<0.05),B조유3례환자무법내수방기청성삽관,개용쾌속유도전마삽관。결론지좌신연합표면마취용우포위청성기관삽관,가일정정도상제고환자청성삽관적서괄도,동시청성삽관환자적혈류동역학경가은정,구유일정적림상응용개치。
Objective To investigate the clinical effects of Dezocine with surface anesthesia used in awake intubation in satiety patients with food intaken. Methods 40 patients with ASAⅠ,II levels were randomly divided into 2 groups, with 20 cases in each group. Patients in group A received 1 mg/mL Dezocine 0.15 mg/kg, and those in group B re-ceived 0.15 mL/kg normal saline. 5 minutes later, conscious endotracheal intubation was respectively performed after throat mouth cavity surface anesthesia and cricothyroid membrane puncture endotracheal surface anesthesia in these two groups. The mean arterial blood pressure (MAP) and heart rate (HR) at the time point of entering operating room (T1), cricothyroid membrane puncture endotracheal surface anesthesia (T2), intubation (T3) and after the intubation (T4) were recorded. Then the incidence of restlessness, nausea, bucking at T2 and T3 were analyzed. Results There was no significant difference between general data of two groups (P>0.05). MAP, HR in group A were significantly lower than group B when awake intubation (P< 0.05, and the intubation times of group B [(8.7±2.7) min] was significantly longer than that of group A [(5.3±1.2) min] (P<0.05). Also the restlessness scores of group B [T2: (1.2±0.7) points, T3: (1.8±0.5) points] were higher than those of group A [T2: (0.4±0.3) .points, T3: (0.6±0.4) points]. The incidence rate of nausea, buking in group B (85%) was higher than that in group A (30%) (P< 0.05), and three patients of group B couldn't tol-erate awake intubation and give up. Conclusion Dezocine combined with surface anesthesia can be used in awake intu-bation in patients with food intaken, which can increase the comfort level and maintain hemodynamics stable. It has certain value in clinical application.
