重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2015年
1期
45-46,49
,共3页
张云飞%陈龙%谭洪婧%周满红
張雲飛%陳龍%譚洪婧%週滿紅
장운비%진룡%담홍청%주만홍
舒芬太尼%插管法,气管内%右美托咪定
舒芬太尼%插管法,氣管內%右美託咪定
서분태니%삽관법,기관내%우미탁미정
sufentanil%intubation,intratracheal%dexmedetomidine
目的:观察不同剂量舒芬太尼复合右美托咪定用于纤支镜引导清醒插管的麻醉效果。方法选择遵义市第一人民医院2012年1月至2013年12月间需要进行纤支镜引导清醒插管的患者118例,分为3组:Ⅰ组(40例)、Ⅱ组(42例)、Ⅲ组(36例)。先给予1μg/kg的右美托咪定,然后持续0.2μg/kg持续泵注后分别静脉注射舒芬太尼0.1μg/kg(Ⅰ组)、0.2μg/kg(Ⅱ组)、0.3μg/kg(Ⅲ组)。记录入手术室后5min作为基础值(T0),注药后(T1),插管即刻窥视会厌(T2),插管后1min(T3),插管后5min(T4),观察心率(HR)、平均动脉压(MAP),脉搏血氧饱和度(SpO2)变化,记录插管过程中不良反应。结果与Ⅰ组相比,Ⅱ、Ⅲ组T2、T3的HR显著降低(P<0.05),Ⅱ、Ⅲ组T2、T3MAP显著降低(P<0.05)。与Ⅰ、Ⅱ组相比,Ⅲ组T2SpO2显著降低(P<0.05)。Ⅰ组发生呛咳反应显著高于Ⅱ、Ⅲ组(P<0.05),只有Ⅲ组发生呼吸抑制。结论静注舒芬太尼0.2μg/kg复合右美托咪定用于纤支镜引导清醒气管插管,能有效抑制应激反应,且循环稳定,不良反应少。
目的:觀察不同劑量舒芬太尼複閤右美託咪定用于纖支鏡引導清醒插管的痳醉效果。方法選擇遵義市第一人民醫院2012年1月至2013年12月間需要進行纖支鏡引導清醒插管的患者118例,分為3組:Ⅰ組(40例)、Ⅱ組(42例)、Ⅲ組(36例)。先給予1μg/kg的右美託咪定,然後持續0.2μg/kg持續泵註後分彆靜脈註射舒芬太尼0.1μg/kg(Ⅰ組)、0.2μg/kg(Ⅱ組)、0.3μg/kg(Ⅲ組)。記錄入手術室後5min作為基礎值(T0),註藥後(T1),插管即刻窺視會厭(T2),插管後1min(T3),插管後5min(T4),觀察心率(HR)、平均動脈壓(MAP),脈搏血氧飽和度(SpO2)變化,記錄插管過程中不良反應。結果與Ⅰ組相比,Ⅱ、Ⅲ組T2、T3的HR顯著降低(P<0.05),Ⅱ、Ⅲ組T2、T3MAP顯著降低(P<0.05)。與Ⅰ、Ⅱ組相比,Ⅲ組T2SpO2顯著降低(P<0.05)。Ⅰ組髮生嗆咳反應顯著高于Ⅱ、Ⅲ組(P<0.05),隻有Ⅲ組髮生呼吸抑製。結論靜註舒芬太尼0.2μg/kg複閤右美託咪定用于纖支鏡引導清醒氣管插管,能有效抑製應激反應,且循環穩定,不良反應少。
목적:관찰불동제량서분태니복합우미탁미정용우섬지경인도청성삽관적마취효과。방법선택준의시제일인민의원2012년1월지2013년12월간수요진행섬지경인도청성삽관적환자118례,분위3조:Ⅰ조(40례)、Ⅱ조(42례)、Ⅲ조(36례)。선급여1μg/kg적우미탁미정,연후지속0.2μg/kg지속빙주후분별정맥주사서분태니0.1μg/kg(Ⅰ조)、0.2μg/kg(Ⅱ조)、0.3μg/kg(Ⅲ조)。기록입수술실후5min작위기출치(T0),주약후(T1),삽관즉각규시회염(T2),삽관후1min(T3),삽관후5min(T4),관찰심솔(HR)、평균동맥압(MAP),맥박혈양포화도(SpO2)변화,기록삽관과정중불량반응。결과여Ⅰ조상비,Ⅱ、Ⅲ조T2、T3적HR현저강저(P<0.05),Ⅱ、Ⅲ조T2、T3MAP현저강저(P<0.05)。여Ⅰ、Ⅱ조상비,Ⅲ조T2SpO2현저강저(P<0.05)。Ⅰ조발생창해반응현저고우Ⅱ、Ⅲ조(P<0.05),지유Ⅲ조발생호흡억제。결론정주서분태니0.2μg/kg복합우미탁미정용우섬지경인도청성기관삽관,능유효억제응격반응,차순배은정,불량반응소。
Objective To observe the effect of different doses of sufentanil on intubation guided by fiber bronchoscope in diffi‐cult airways .Methods One hundred and eighteen patients with difficult airways who underwent tracheal intubation were randomly divided into 3 groups [groupⅠ(n=40) ,groupⅡ (n=42) ,and groupⅢ (n=36)] .First all group received 1 μg/kg dexmedetomi‐dine ,then groupⅠ ,groupⅡ and group Ⅲ received sufentanil 0 .1μg/kg ,0 .2 μg/kg ,0 .3μg/kg infusion in bolus respectively .Heart rate(HR) ,mean arterial pressure(MAP)and saturation of pulse oximetry(SpO2 )were recorded at 5 min after patients arriving at operation room (T0 ) ,after drug infusion(T1 ) ,the time of intubation and seeing the epiglottis (T2 ) ,1 min(T3 )and 5 min(T4 )after intubation .side effect was recorded throughout the process .Results HR at T2 and T3 in groupⅡ and group Ⅲ were significantly lower than those in group Ⅰ(P<0 .05) .MAP at T2 and T3 in groupⅡ and group Ⅲ were significantly lower than those in groupⅠ(P<0 .05) .SpO2 at T2 in group Ⅲ was significantly lower than those of groupⅠ and groupⅡ(P<0 .05) .Cough reflex in groupⅠwas much frequent than others .Only group Ⅲ had respiratory inhibition .Conclusion Intravenous sufentanil (0 .2 μg/kg)could in‐hibit effectively stress reaction from endotracheal intubation ,in which less side effects such as haemodynamic changes and respirato‐ry depression occur .