右美托咪定联合地佐辛用于帝视内镜引导清醒插管的应用价值

Application of Dexmedetomidine combination with Dezocine in awake intubation guided by dioscorea

目的探讨右美托咪定联合地佐辛镇静用于帝视内镜引导清醒气管插管的应用价值。方法选择2017年8月~2018年1月我院行全身麻醉手术需清醒气管插管的患者40例,随机分为A、B两组。A组采用咪达唑仑与舒芬太尼静脉注射镇静,B组采用右美托咪定泵注联合地佐辛进行镇静,记录入室时(T_0)、插管前(T_1)、气管导管经声门即刻(T_2)、拔管后10 min(T_3)4个时刻患者的MAP和HR,运用Ramsay评分、插管耐受度评分、满意度评分对插管过程进行评价,记录出现呼吸抑制的患者数。结果 40例均插管成功,T_3时B组Ramsay评分优于A组(P<0.05);给药后两组MAP及HR均降低,在T_1、T_2时,差异有统计学意义,B组在T_3时降低,差异有统计学意义(P<0.05),在T_3时,B组HR低于A组,差异有统计学意义(P<0.05),B组插管满意度优于A组,差异有统计学意义(P<0.05);B组未出现呼吸抑制患者。结论右美托咪定联合地佐辛在插管时与拔管后血流动力学更稳定,镇静效果更好,患者满意度更高,值得临床应用推广。

Objective To investigate the effects of Dexmedetomidine combined with Dezocine for application of awake intubation guided by disposcope endoscope.Methods From August 2017 to January 2018,40 patients required intubation in our hospital were randomly divided into group A and B.Group A was treated intravenous injection of Midazolam and Sufentanil;group B was treated intravenous infusion of Dexmedetomidine,intravenous injection of Dezocine.The MAP and HR were recorded.,and the recording time was 4 times in operation room（T_0）,before intubation（T_1）,after tracheal intubation（T_2） and 10 min after extubation（T_3）,using Ramsay Score,intubation tolerance score satisfaction score to evaluate intubation process and,the number of patients with respiratory depression was recorded.Results All of the 40 patients were successfully intubated.The score of Ramsay in group B was superior to that of group A at T_3（P〈0.05）.MAP and HR of both groups were decreased after treatment,with statistical difference at T_1 and T_2,while group B（P〈0.05）.At T_3,the HR of group B was lower than that of group A（P〈0.05）,and the satisfaction of group B was better than that of group A（P〈0.05）.And no patients with respiratory depression in group B.Conclusion With the application of Dexmedetomidine combined with Dezocine,in the process of intubation and extubation in patients with more stable hemodynamics;patients with sedative effect and higher satisfaction;it is worthy of clinical application.