天津医药

• 药物临床观察 • 上一篇    下一篇

右美托咪定在纤维支气管镜引导下经鼻清醒气管插管中的应用

张丽   

  1. 天津市第四中心医院
  • 收稿日期:2011-09-08 修回日期:2012-01-29 出版日期:2012-08-15 发布日期:2012-08-15
  • 通讯作者: 张丽

Dexmedetomidine infusion for sedation during awake fibreoptic nasal intubation

  • Received:2011-09-08 Revised:2012-01-29 Published:2012-08-15 Online:2012-08-15

PDF (PC)

2567

摘要： 摘要 目的：探讨右美托咪定在清醒局部麻醉下，纤支镜引导经鼻气管插管中的应用。 方法：择期拟行口腔手术患者30例，ASAⅠ～Ⅱ级，年龄21～72岁，体重46～85kg，随机分为右美托咪定组（n=15）和芬太尼组（n=15）。分别给予1μg/kg右美托咪啶和1μg/kg芬太尼， 10分钟静脉泵注完毕，局部浸润麻醉下行经鼻纤支镜引导清醒气管插管。记录插管时间，入室 (T1)、辅助药物泵注结束即刻（T2）、插管成功即刻（T3）三个时点的HR、BP、SpO2、BIS的变化及Ramsay镇静评分，病人耐受度和满意度评分。 结果：右美托咪啶组的HR、SBP、BIS和Ramsay评分的时间效应差异有统计学意义（P<0.05），T3时点HR、SBP、BIS和Ramsay评分组间比较差异有统计学意义（P<0.05），患者的耐受度和术后满意度评分均优于芬太尼组（P<0.05）。 结论：右美托咪定应用于清醒状态纤支镜引导下经鼻气管插管，具有镇静良好、呼吸无抑制和血流动力学稳定的优势。

关键词: 右美托咪定, 清醒, 纤支镜, 经鼻气管插管

Abstract: 【Abstract】 Objective To evaluate the effects of dexmedetomidine infusion on sedation of patients undergoing awake fibreoptic nasal intubation. Methods Thirty ASAⅠ or Ⅱpatients aged 21～72 yr weighing 46～85kg scheduled for elective oral surgery were randomly allocated into 2 groups ( n=15 each): dexmedetomidine group(group D)and fentanyl group(group F). Patients in group D received dexmedetomidine 1μg/kg infusion. Patients in group F received fentanyl 1μg/kg infusion. The fiberoptic nasal intubation time was recorded. The changes of HR, BP, SPO2, BIS, sedation (the Ramsay score), satisfaction in the two group at T1 (before drug administration), T2 (after drug administration) and T3 (intubation) were observed. Results Compared with T1, HR obviously decreased at T2、T3 in group D, while the Ramsay score is increased（P <0.05）. Compared with group F,the change of SBP at T3 is small（P <0.05）. There were no significantly differences of BIS, SPO2 at T1 , T2 , T3 （P >0.05）.The patient’s tolerance and satisfaction scores of group D were better than Group F（P <0.05）. Conclusion Combination of dexmedetomidine loading with topic anaesthesia can allow better sedation, stable haemodynamic status, absence of respiratory depression in awake fibreoptic nasal intubation.

Key words: Dexmedetomidine, awake, fibreoptic nasal intubation.