右美托咪定辅助纤维光导支气管镜清醒插管的临床应用

Study on the Clinical Application of Dexmedetomidine in Assisting Fiberoptic Induced Awake Intubation with Difficult Airway

纤维光导支气管镜引导清醒气管插管是处理可预测困难插管的常用方法。完成清醒状态下的气管插管,患者紧张焦虑、操作刺激剧烈,容易出现呛咳、躁动等插管反应及强烈的心血管反应。右美托咪定是高选择性α2肾上腺素能受体激动剂,具有中枢抗交感作用,对呼吸无明显抑制作用,能产生近似自然睡眠的镇静作用,特别适用于辅助清醒状态下纤维光导支气管镜引导困难气管内插管。

Fiberoptic bronchoscope induced awake intubation is the gold standard of management of predicted difficult airway.Awake intubation may cause cough,agitation and severe cardiovascular side effects in anxious patients.Dexmedetomidine,which is highly selective agonist for α2adrenergic receptor,has central antisympathetic effect.It can produce profound sedation similar to natural sleep without causing respiratory depression,therefore,it is especially suitable to be used to facilitate fiberoptic bronchoscope induced awake intubation in difficult airway management.