预防经鼻盲探气管插管所致应激反应的麻醉方法探讨

Study on prevention of stress response during blind treacheal intubation via nasal cavity

目的:探讨预防患者在半清醒状态下接受经鼻盲探气管插管所致精神不良刺激及心血管反应的麻醉方法。方法:45例患者分为三组,A组予氟氛合剂静注、丁卡因表麻;B组予咪唑安定静注、利多卡因表麻;C组予咪唑安定和氟氛合剂静注、丁卡因表麻。记录患者各期的HR、SBP、RPP变化情况及对插管过程的遗忘情况。结果:C组插管后各期的HR、SBP、RPP与诱导前无明显差异(P>0.05);患者对插管过程的遗忘率高于A、B两组。结论:咪唑安定和氟氛合剂静注加丁卡因表麻适于经鼻盲探气管插管。

Objective： To evaluate the proper anesthesia method which could prevent the psychological stimulation and cardiovascular side- reaction during semiconscious blind nastracheal intubation. Methods： Fourty- five patients were divided into 3 groups randomly. GrouPA underwent intravenous injection of Innovar combined with surface anesthesia of dicaine. GrouPB underwent surface anesthesia of lidocaine combined with intravenous injection of Midazolam. GrouPC underwent intravenous injection of Midazolam and Innovar combined with surface anesthesia of dicaine. The HR, SBPof patients in every period during anesthesia and the amnesia post-anesthesia were recorded. Results： The HR, SBPof patients in grouPC have no significant difference between at pre-induction and every period during anethsethia（P〉0.05）. The percentage of patients with amnesia in grouPC was higher than A and B. Conclusions： Intravenous anethsesia of Midazolam and Innovar combined with surface anesthesia of dicaine is suitable for blind nasotracheal intubation.