摘要
目的探讨瑞芬太尼对经鼻清醒气管插管反应的影响。方法选择要经鼻气管插管全麻下行手术的患者42例,随机分为瑞芬太尼组(R组)22例和对照组(C组)20例。两组气管插管操作前10min均静脉注射咪达唑仑0.1mg/kg,2%利多卡因作鼻腔至气管的表面麻醉;R组快速输注瑞芬太尼1.0μg/kg(30s内注射完毕),再以0.1μg(/min·kg)持续静脉输注。记录给药、插管过程中的HR、MAP、SpO2、警觉/镇静(OAA/S)评分和患者对喉镜显露和气管插管操作反应评分。结果两组插管过程中SpO2变化无统计学意义(P>0.05)。与C组相比较R组导管插入时及插管后1min MAP较低(P<0.05);喉镜暴露声门时、导管插人时及插管后1minHR较低(P<0.05);OAA/S评分、患者对喉镜显露和气管插管操作反应评分下降(P<0.05)。结论瑞芬太尼可减轻经鼻清醒气管插管患者的插管反应,安全可行。
Objective Explore the infusion of remifentanil for awake nasotracheal intubation reaction. Methods chosen to nasal intubation anesthesia patients 42 cases, werw randomly divided into control group（n=20） and remifentanil group（n=22）. Midazolam as premedication was given intravenously with a dose of 0.1 mg/kg 10min before nasotracheal intubation was carried out and superficial anesthesia from nasal cavity to upper trachea with 2% lidocaine were administered to both two groups.remifentanil group also 1.0μg/kg rapid infusion of remifentanil,then 0.1μg/min＇kg continuous infusion. Recorded dehvery,intubation in the process of HR,MAP,SpO2, OAA/S score and patients exposed to laryngoscopy and tracheal intubation response operation score. Results No SpO2 changes were observed during the procedure（P〉0.05）, but MAP was singnificantly lower in remifentanil group during induction of anesthesia,immediately and 1 min after intubation （P〈 0.05 ）. Glottic exposure laryngoscope, the catheter insertion and intubation at 1 rain HR was lower （P〈 0.05）, OAA/S score,laryngoscopy and tracheal intubation operation revealed reaction score decreased（P〈0.05）. Conclusion Remifentanil infusion can reduce nasal awake intubation tracheal intubation of patients respond,and is a safe.
出处
《中国现代医生》
2009年第32期76-78,共3页
China Modern Doctor
