右美托咪啶用于困难气道清醒慢诱导气管插管30例  

Application of Dexmedetomidine in 30 Cases of Difficult Airway Undergoing Awake Slow Induction Intubation

作　　者：邵雪泉[1] 余洁[1] 潘中心[1] 郑丽花[1] 

机构地区：[1]浙江省衢州市人民医院麻醉科,衢州324000

出　　处：《中国中西医结合外科杂志》2014年第2期148-150,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:观察右美托咪定用于困难气道清醒慢诱导气管插管的安全性及有效性。方法:预测有困难插管的择期性手术患者60例。采用随机数字法分为健忘镇痛组(H组)和右美托咪定组(D组)。两组患者预注量分别维持至插管成功。结果:D组诱导后即刻MAP和HR降低,H组HR和MAP升高(P<0.05);D组气管插管条件和患者气管插管的耐受性、首次插管的成功例数、2次及2次以上操作成功的例数明显提高,插管时间明显缩短(P<0.05);呼吸抑制发生率H组多于D组(P<0.05)。结论:右美托咪定用于困难气道清醒慢诱导气管插管镇静镇痛效果良好,并能提供更为满意的气管插管条件及耐受性,围麻醉诱导插管期呼吸、循环稳定。Objective To observe the safety and efficacy of dexmedetomidine in awake patients of difficult airway during slow induction endotracheal intubation. Methods A total of 60 selective surgical patients ex-pected to have difficult endotracheal intubation were enrolled. According to the random number table method, all patients were evenly allocated to the slow amnesia analgesia group （Group H）, and the dexmedetomidine group （Group D）. The initial doses were maintained until the intubation was accomplished in both groups. Results The post-induction MAP and HR dropped significantly in Group D, while a significant increase was observed in Group D （P〈0.05）. Compared to Group H, patients in Group D demonstrated better conditions and toler- ance of intubation, shorter intubation time and less cases that needed 2 or more attempts of intubation in Group H （P 〈 0.05）.The incidence of respiratory inhibition was higher in Group H than in group D（P 〈 0.05）. Conclusion Dexmedetomidine demonstrates excellent analgesic effects, facilitates endotracheal intubation, im-proves tolerance, while maintaining respiratory and hemodynamic stability for patients with difficult airway.

关 键 词：右美托咪定 镇静 慢诱导 清醒气管插管 

分 类 号：R971.1[医药卫生—药品]