右美托咪定与舒芬太尼辅助表面麻醉对减轻清醒气管插管患者心血管反应的临床效果比较

Clinical Efficacy of Dexmedetomidine and Sufentanil Assisted as Topical Anesthesia in Relieving Cardiovascular Response in Endotraeheal Intubation

[目的]比较右美托咪定与舒芬太尼辅助表面麻醉对减轻清醒气管插管患者心血管反应的效果。[方法]本院经口清醒气管插管患者92例，随机单盲分为观察组（47例）与对照组（45例），在利多卡因和丁卡因联合表面麻醉前提下，观察组插管前泵注右美托咪定，对照组静脉注射舒芬太尼，记录并对比两组表面麻醉前（T0）、插管后即刻（T1）、插管后3min（T2）、插管后5min（T3）去甲肾上腺素（NE）、收缩压（SBP）、舒张压（DBP）、心率（HR）的变化情况。[结果]①两组患者插管后NE、SBP、HR均较之基础值呈现一过性升高，T3时各指标基本恢复至基础值水平；②T1时对照组NE、SBP、DBP、HR等指标远高于观察组水平，且差异均具有显著性（P〈0．05）；T2时两组NE、SBP相比较差异具有显著性（P〈0．05）；T3时两组NE相比较差异具有显著性（P〈0．05）。[结论]清醒状态下经口气管插管中使用右美托咪定辅助表面麻醉较之舒芬太尼对减轻心血管反应具备比较优势。

[Objective]To compare the clinical efficacy of dexmedetomidine and sufentanil assisted as topical anesthesia in relieving cardiovascular response in endotracheal intubation.[Methods] Ninety-two awake tracheal intubation patients admitted in our hospital were randomly （single blind） divided into observation group （47 cases） and control group（45 cases）.Under supplementary topical anesthesia of Lidocaine and Dlcalne, the observation group was infused with dexmedeto- midine before intubation, and the control group conducted intravenous injection of sufentanil. The changes of the following of the two groups were recorded and compared： Surface anesthesia （T0）, immediately after intubation （T1）, 3 min after intubation （T2）, 5 rain after intubation （T3）, norepinephrine （NE）, systolic blood pressure （SBP）, diastolic blood pressure （DBP） and heart rate （HR）.[Results] （1）After intubation, NE, SBP and HR in the two groups showed a transient increase compared with the basal yalues, all of the indexes were basically restored to the level of basic values at T3 ;（2） At T1, NE, SBP, DBP, HR index of the control group were higher than those of the observation group, and the differences were significant （ P 〈0.05） ; The difference of NE and SBP in the two groups at T2 was significant （ P 〈0.05） ; there was significant difference between the two groups in NE at T3 （P 〈 0. 05 ）. [Conclusion] Compared with Sufentanil, Dexmedetomidine used in endotracheal intubation assisted with topical anesthesia has comparative advantages to relieve cardiovascular responses.