布托啡诺联合咪达唑仑用于ICU患者气管插管麻醉诱导研究

Study on anesthesia induction of butorphanol combined with midazolam for tracheal intubation of ICU Datients

目的观察布托啡诺联合咪达唑仑用于ICU患者气管插管前的麻醉诱导效果。方法选择我科2014年1月至2015年10月行床旁气管插管的70例患者,按照随机数字法分为试验组与对照组,每组35例。试验组(BM组)予以布托啡诺0.04 mg/kg联合咪达唑仑0.05 mg/kg静脉注射诱导麻醉,对照组(M组)气管插管前予以同体积0.9%生理盐水联合咪达唑仑0.05 mg/kg静脉推注诱导麻醉,观察两组患者在药物注射前(T_1)、插管即刻(T_2)以及插管后5 min(T_3)的血流动力学变化及喉镜置入时发生剧烈呛咳、反流等不良反应情况。结果与M组比较,BM组患者在T_2、T_3时MAP、HR变化小,剧烈呛咳、反流等插管不良反应发生率低。结论布托啡诺联合咪达唑仑用于ICU患者气管插管前麻醉诱导,可减少患者的血流动力学改变及气管插管时呛咳、反流等不良反应的发生。

Objective To investigate the effect of anesthesia induction of butorphanol combined with midazolam on tracheal intubation for patients in intensive care unit（ICU）.Methods Seventy patients with tracheal intubation were randomly divided into two groups.Patients in experiment group（group BM,n =35） were given intravenous anesthesia induction of butorphanol 0.04 mg/kg and midazolam 0.05 mg/kg,while the anesthesia induction in control group（group M,n = 35） was with the same volume of 0.9%physiological saline and midazolam（0.05 mg/kg）.The hemodynamic changes before drug induction（T0）,immediately after intubation（T1）,and at 5 min（T2） after intubation were recorded.The adverse reactions,such as severe cough and reflux,which occurred during the placement of laryngoscope were observed.Results The changes in HR and MAP in group BM were fewer than those of group M,and the adverse reaction rate was lower.Conclusion Butorphanol combined with midazolam for ICU patients with tracheal intubation before anesthesia can reduce the hemodynamic changes and the occurrence of severe cough and reflux during the endotracheal intubation.