小剂量舒芬太尼盲探气管插管评价  

Low dosage sufentanil for blind nasotracheal intubation

作　　者：李源[1] 徐礼鲜[1] 张国良[1] 卢玲玲[1] 张惠[1] 徐瑞芬[1] 

机构地区：[1]西安第四军医大学口腔医学院麻醉科,710032

出　　处：《实用口腔医学杂志》2005年第6期826-828,共3页Journal of Practical Stomatology

摘　　要：目的: 评价小剂量舒芬太尼在经鼻盲探气管插管术中静脉镇静、镇痛的效果.方法:选口腔颌面外科手术的患者60 例,随机分为3 组,每组20 例,Ⅰ组:芬太尼-咪唑安定,Ⅱ组:氟哌啶-芬太尼,Ⅲ组:舒芬太尼.术前肌注阿托品-咪唑安定.3 组均按常规表面麻醉后开始插管,比较患者入室后静脉注药前(T1)、静脉注药后(T2)、插入管后 (T3)的BP、HR、MAP、SpO2;记录有无插管并发症、插管成功率、镇静程度、患者满意度和遗忘程度.结果:与T1 时间比较, Ⅰ、Ⅱ组在T2 时间点Ramsay score有明显上升,达3～5 分, MAP、SpO2下降(P<0.05); T3时间MAP和HR 均有不同程度的升高;Ⅲ组患者在T2 时间点以后呈轻度镇静,无焦虑,注意力下降状态,Rmasay score达2～3 分,MAP、 SpO2改变不明显,HR与T1时间比较明显下降(P<0.05).3 组气管插管操作过程遗忘的发生率及镇静、镇痛的满意度比较无显著差别(P>0.05).结论:小剂量的舒芬太尼可适用于盲探气管插管术中患者镇静和镇痛,并在降低心血管副反应方面具有一定的优势.Objective：To evaluate the effects of low dosage sufentanil used for blind nasotracheal intubation. Methods：Sixty cases for maxillnfacial surger： were divided into 3 groups randomly with 20 in each group. Patients in group Ⅰ were administered with fentanyl and midazolam by vein, those in group Ⅱwith fentanyl and droperidol by vein,those in group Ⅲ with sufentanil at 0. 1 - 0.2 μg/kg. Intramuscular premedication of atropine - midazolam and blind nasotracheal intubation were pertormed in all cases after surface anesthesia for routine. Blood pressure（BP）, heart rate （ HR）, mean artery pressure （ MAP）, blood oxygen saturation of pulse （ SpO2 ）, intubation complication（ IC）, intubation achievement ratio（IAR）, sedation score （Ramsay score）, patient satisfaction（PS）, and the incident rate of amnesia（IRA） in the three groups at TI （before administering drug）, T2 （after administering drug） and T3 （when tracheal tube was inserted into tracheal） were measured and observed. Results：In groups Ⅰ and Ⅱ Ramsay score increased to 3 - 5, MAP and SpO2 decreased （P 〈 0.05） at T2 ; MAP and HR inereased in group Ⅰ and Ⅱat T3 （ P 〈 0.05）. In group Ⅲ, Rmasay score was 2 - 3, MAP and SpO2 were kept stable, HR decreased （ P 〈 0.05 ） after T2. IRA, PS and amnesia for intubation procedure were not significant difference in three groups （ P 〉 0.05 ）. Conclution： The low dose sutentanil can be applied for the sedation and analgesic before blind nasotracheal intubation.

关 键 词：舒芬太尼 经鼻盲探气管插管 镇静 镇痛 

分 类 号：R782.054[医药卫生—口腔医学]