右美托咪定在纤支镜清醒气管插管中的应用  

The application of Dexmedetomidine in awake fiberoptic bronchoscopy intubation

作　　者：王兵[1] 

机构地区：[1]成都市第二人民医院麻醉科,四川成都610031

出　　处：《四川医学》2012年第5期816-818,共3页Sichuan Medical Journal

摘　　要：目的探讨右美托咪定在纤支镜清醒气管插管中对心血管系统的影响。方法选择需清醒气管插管,全麻下行手术患者30例,年龄32～66岁,ASA I～Ⅱ级,所有患者均无心、脑血管疾病。随机分为两组(n=15):A组静脉输注右美托咪定1μg/kg,B组静脉输注咪达唑仑0.1mg/kg,10min输注完毕。A、B两组均给予舒芬太尼0.1μg/kg静脉缓推和2%利多卡因表面麻醉后行纤支镜清醒鼻腔插管,观察患者MAP、HR、SpO2及插管所用时间。结果 A组所有患者镇静满意,均能很好耐受清醒气管插管,插管过程中MAP、HR和SpO2稳定(P>0.05)。B组镇静时有轻度呼吸抑制,插管过程中MAP和HR升高(P<0.05),插管成功率低于A组(P<0.05)。结论右美托咪定用于纤支镜清醒气管插管镇静有效,无呼吸抑制,血流动力学稳定,是理想的辅助用药。Objective Discussion the effects dexmedetomidine in awake fiberoptic intubation on the cardiovascular system.Methods Choose need to awake tracheal intubation,General anesthesia surgery 30 patients,aged 32 to 66 years,ASA I-Ⅱ grade,all patients were no cardiovascular disease,and cerebrovascular disease.Randomly divided into two groups（n=15）： A group of intravenous infusion of dexmedetomidine given 1μg/kg,B group of intravenous infusion of midazolam 0.1mg/kg,10min infusion is completed.A,B groups were given intravenous sufentanil 0.1μg/kg slowly push and the surface 2% lidocaine anesthesia,awake fiberoptic nasal intubation was observed in patients with MAP,HR,SpO2,and intubation of patients with time.Results Dexmedetomidine group,all patients given sedation satisfaction,were well tolerated awake tracheal intubation,during intubation MAP,HR and SpO2 stable（P〈0.05）.Midazolam group had mild respiratory depression and sedation,intubation,MAP and HR increased during（P〈0.05）.intubation success rate is lower than the dexmedetomidine group（P〈0.05）.Conclusion Given dexmedetomidine sedation for fiberoptic awake intubation is effective,no respiratory depression,hemodynamic stability,is an ideal adjuvant drug.

关 键 词：右美托咪定 纤支镜 咪达唑仑 清醒气管插管 

分 类 号：R614[医药卫生—麻醉学]