电针穴位刺激联合右美托咪定在困难气道患者行清醒气管插管中的应用  

Application of electroacupuncture acupoint stimulation combined with dexmedetomidine in awake tracheal intubation for patients with difficult airway

作　　者：原珮江 张栩峥 王景华 YUAN Pei-jiang;ZHANG Xu-zheng;WANG Jing-hua(Department of Anesthesiology,1.Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine;Guangdong Provincial People s Hospital Zhuhai Hospital,Zhuhai Jinwan Central Hospital,Zhuhai 519000,Guangdong;The 305 Hospital of the Chinese People s Liberation Army,Beijing 100017,China)

机构地区：[1]珠海市中西医结合医院麻醉科 [2]广东省人民医院珠海医院·珠海市金湾中心医院麻醉科,广东珠海519000 [3]中国人民解放军第三〇五医院麻醉科,北京100017

出　　处：《川北医学院学报》2023年第6期789-792,共4页Journal of North Sichuan Medical College

基　　金：广东省珠海市医学科研基金项目(ZH3310200029PJL)。

摘　　要：目的:探讨电针穴位刺激联合右美托咪定在困难气道患者行清醒气管插管中的应用效果。方法:选取98例拟行气管插管术且术前评估为困难气道的患者为研究对象,根据干预方式不同分为对照组与电刺激组,每组各49例。对照组予以右美托咪定1μg/kg泵入,15 min内输注完毕再行气管插管;电针组在右美托咪定泵注的同时予以电刺激双侧内关穴、曲池穴(频率2/100 Hz,疏密波)15 min。比较两组患者围手术期心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))、Ramsay镇静评分及插管不良反应发生率和插管舒适度评分。结果:与T0时刻比较,两组T1、T2时MAP、HR均增高(P<0.05);且T2时,电针组低于对照组(P<0.05);T1、T3时,两组MAP、HR无统计学差异(P>0.05)。两组各时间点SpO_(2)比较,差异均无统计学意义(P>0.05)。T1、T2时,电针组Ramsay镇静评分高于对照组(P<0.05)。电针组插管不良反应发生率低于对照组(P<0.05);舒适度评分优于对照组(P<0.05)。结论:电针穴位刺激联合右美托咪定用于困难气道患者清醒气管插管可有效抑制插管应激反应,增强镇静效应,降低插管不良反应发生率,改善患者舒适度。Objective:To explore the application effect of electroacupuncture acupoint stimulation combined with dexmedetomidine in awake tracheal intubation in patients with difficult airway.Methods:98 patients with difficult airway undergoing tracheal intubation were divided into control group and electrical stimulation group according to different intervention methods,49 cases in each group.The control group was given dexmedetomidine 1μg/kg pump,15 min infusion,and then tracheal intubation,the electroacupuncture group was given dexmedetomidine pump injection and electrical stimulation of bilateral Neiguan and Quchi points(frequency 2/100 Hz,density wave)for 15 min.Heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO_(2)),Ramsay sedation score,adverse reactions and intubation comfort score were compared between the two groups.Results:Compared with T0,MAP and HR increased at T1 and T2 in both groups(P<0.05).Compared with the control group,MAP and HR were lower in the electroacupuncture group at T2(P<0.05).There was no significant difference in MAP and HR between the two groups at T1 and T3(P>0.05).There was no significant difference in SpO_(2) between the two groups at each time point(P>0.05).Compared with the control group,the Ramsay sedation score at T1 and T2 in the electroacupuncture group increased(P<0.05).Compared with the control group,the incidence of intubation adverse reactions in the electroacupuncture group was lower(P<0.05).The comfort score of the electroacupuncture group was better than that of the control group(P<0.05).Conclusion:Electroacupuncture acupoint stimulation combined with dexmedetomidine for awake tracheal intubation in patients with difficult airway can effectively inhibit intubation stress response,enhance sedation effect,reduce the incidence of intubation adverse reactions,and improve patient comfort.

关 键 词：气管插管 困难气道 电针穴位刺激 右美托咪定 应激反应 舒适度 

分 类 号：R614.2[医药卫生—麻醉学]