靶控舒芬太尼在口腔颌面外科困难气道盲探气管插管中的应用

Target-controlled sufentanil infusion used in blind tracheal intubation in oral and maxillofacial surgery for patients with difficult airway

目的:比较舒芬太尼和芬太尼靶控在口腔颌面外科困难气道盲探气管插管中的效果。方法:42例伴有困难气道口腔颌面外科择期全麻手术患者,随机分为舒芬太尼组(I组)和芬太尼组(II组),每组21例。麻醉诱导前5 min(T0)、达效应靶浓度时(T1)、气管导管插入时(T2)和插管后1 min(T3)记录收缩压(SBP)、舒张压(DBP)、心率(HR)、呼吸(R)和血氧饱和度(SPO2)。结果:I组T1、T2、T3各参数与T0比较差异无显著性(P>0.05)。II组SBP、DBS、HP在T2与T0比较明显上升(P<0.01)。T2时点,I组SBP、DBP较II组降低(P<0.05)。T2时点II组R较I组明显增高(P<0.01)。I组镇静评分和满意度明显高于II组(P<0.01)。结论:靶控舒芬太尼用于口腔颌面外科盲探气管插管优于芬太尼。

Objective：To compare the effects of sufentanil and fentanyl target control infusion used in blind tracheal intubation in oral and maxillofacial surgery for patients with difficult airway.Methods： 42 patients with difficult airway scheduled for oral and maxillofacial operations were selected and randomly divided into 2 groups（n=21）.Sufentanil was given to the patients in group Ⅰ and fentanyl in group Ⅱ.The changes of systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）,respiration rate（R） and the degree of blood oxygen saturation（SPO2） of the patients in the two groups at T0（5 minutes before induction of anesthesia）,T1（up to the target effect concentration）,T2（the insertion of tracheal tube） and T3（5 minutes after the insertion of tracheal tube）were measured.Results： In group I,there were no significant differences（P〈0.05） of the measurements at T1,T2 and T3 compared with those at T0.In group II,SBP,DBS and HP increased at T2 obviously（P〈0.01） compared with those at T0.SBP and DBP in group I descended at T2（P〈0.05）,while R in group I was normal,but in group II increased（P〈0.01）.The sedation score in group I was obviously higher than that in group II（P〈0.01）.Also the patients＇ satisfaction was higher in group I than in group II（P〈0.01）.Conclusion： Target-controlled infusion of sufentanil or fentanyl in oral and maxillofacial surgery is feasible for patients with difficult airway,sufentanil is more effective.