右美托咪啶复合舒芬太尼、丁卡因表面麻醉用于纤维支气管镜引导插管的疗效观察  

Dexmedetomidine combined with Sufentanil,topical Tetracaine anesthesia for fiberoptic intubation effect observation

作　　者：邓信林[1] 胡宏强[1] 沈七襄[1] 蔡铁良[1] 高鹏[1] 徐昌顺[1] 

机构地区：[1]厦门大学附属成功医院(解放军第174医院)麻醉科,福建厦门361003

出　　处：《临床军医杂志》2013年第3期257-259,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨右美托咪啶静脉复合舒芬太尼、丁卡因混合液环甲膜注射麻醉技术用于纤维支气管镜(以下简称纤支镜)引导下气管内插管的可行性及安全性。方法困难气道需气管内插管患者60例,其中男39例,女21例,将其分为A、B两组,A组40例,采用右美托咪啶0.5μg/kg,12 min内泵入,1%丁卡因2 ml+舒芬太尼20μg环甲膜注入后5 min,在纤支镜引导下行气管内插管;B组20例,除1%丁卡因2 ml内不加舒芬太尼外,其他方法相同。观察纤支镜和气管导管进入声门、气管时的BP,HR,SpO2值及咳嗽反应。结果 A组患者镇静合作,纤支镜、气管导管进入声门过程中95%(38/40)患者无呛咳,BP,HR平稳,SpO2正常,5%(2/40)患者仅有轻咳;B组患者几乎全部明显咳嗽。结论右美托咪啶0.5μg/kg静脉镇静复合舒芬太尼、丁卡因表面麻醉用于纤支镜引导下困难气道的气管内插管是一种安全,有效,无痛,便捷的麻醉方法。Objective To investigate Dexmedetomidine combined with Sufentanil and Tetracaine mixed liquid membrane injection anesthesia technique for bronchoscopy guided endotraeheal intubation feasibility and its safety. Methods Sixty patients （39 males, 21 females ） with difficult airway who required eudotracheal intubation were divided into Group A（ n = 40） and Group B （n = 20）. Group A was treated with Dexmedetomidine （0.5 μg/kg） pumped in 12 minutes, 1% Tetraeaine （2 ml） ＋ Sufentanil （20μg） via cricothyroid membrane implantation 5 minutes later, and bronchoscopy guided endotracheal intubation, and Group B with the same except that Sufentanil was not added to 1% Tetracainc （2 ml）. BP, HR, SpO2 and cough response were observed while fibrobronchoscopy, as well as endotracheal tube, was passing through the glottis. Results In Group A, the patients were sedative without choking in 95% （38/40） ones, and their BP, HR and SpO2 kept stable, and 5% （2/40） patients suffered from mild cough. In Group B, almost 100% patients suffered from cough. Conclusion Dexmedetomidine sedation via vein combined with Sufentanil and Tetracaine anesthesia is a safe, effective, painless, convenient anesthesia method to those with difficult airway for bronchoscopy guided endotracheal intubation.

关 键 词：右美托咪啶 舒芬太尼 纤支镜 气管内插管 

分 类 号：R971.2[医药卫生—药品]