重症监护患者气管插管麻醉诱导研究

Induction of anesthesia by tracheal intubation in critically ill patients

目的探析不同麻醉诱导方案用于重症监护患者气管插管麻醉诱导中的麻醉效果。方法选取2014年6月~2016年6月本院ICU科室收治的53例行床气管插管患者为本次研究的观察组,选取2012年5月~2014年5月本院ICU科室收治的54例行床气管插管患者为本次研究的对照组。对照组患者在气管插管前使用生理盐水联合咪达唑仑进行诱导麻醉,观察组患者在气管插管前使用布托啡诺联合咪达唑仑进行诱导麻醉,对两组麻醉效果及麻醉安全性进行对比分析。结果插管前,两组患者的平均动脉压(83.23±6.59)、(84.78±5.96)心率(79.85±8.46)、(81.32±6.68)相比差异无统计学意义;插管期间,两组患者均出现平均动脉压、心率升高的情况,且对照组患者的上述指标(106.32±6.75)mmHg、(101.34±4.56)次/min明显高于观察组(92.65±4.78)mmHg、(84.77±8.46)次/min(P<0.05);插管5 min后,观察组患者的平均动脉压(84.12±6.59)mmHg、(82.23±6.54)次/min心率均明显降低(P<0.05),且观察组患者的上述指标与插管前差异无统计学意义。观察组患者的不良反应发生率为9.43%,与对照组患者的25.91%相比差异有统计学意义(P<0.05)。结论布托啡诺联合咪达唑仑用于重症监护患者气管插管麻醉诱导,可获得较为理想的麻醉效果,保障患者的血压及心率稳定。同时,可减少喉镜置入期间不良反应发生率,提高临床麻醉的安全性和有效性,可在临床上进一步应用和推广。

Objective The effect of different anesthesia induction in the induction of anesthesia scheme for severe tracheal intubation anesthesia on patient care.Methods From June2014to June2016in our hospital ICU Department admitted53cases of bed tracheal intubation patients as the observation group in this study,from May2012to May2014in the hospital ICU Department admitted54cases of patients with tracheal intubation bed as the control group in this study.The control group was treated with saline before tracheal intubation combined with midazolam induced anesthesia,patients in the observation group using Bhutto butorphanol before tracheal intubation combined with midazolam induced anesthesia on two.Group of anesthesia effect and comparative analysis of the safety of anesthesia.Results Before intubation,the mean arterial pressure of two groups of patients(83.23±6.59),(84.78±5.96)heart rate(79.85±8.46),(81.32±6.68)no significant difference;during intubation,two groups of patients presented with mean arterial pressure,heart rate the situation of the increase,and the index patients(106.32±6.75)mmHg,(101.34±4.56)/min was significantly higher than the observation group(92.65±4.78)mmHg,(84.77±8.46)times/min(P<0.05);5min after intubation,the mean arterial pressure in patients of observation group(84.12±6.59)mmHg,(82.23±6.54)times/min heart rate were significantly decreased(P<0.05),and the observation index and intubation group patients before the difference was not statistically significant.The adverse reactions were observed the incidence was9.43%,compared with the control group of25.91%patients was statistically significant(P<0.05).Conclusion Bhutto butorphanol combined with midazolam for patients with severe tracheal intubation anesthesia care,can obtain more To guarantee the effect of anesthesia,blood pressure and heart rate in patients with stable.At the same time,can reduce the incidence of adverse reactions during laryngoscopy,improve the safety and effectiveness of clinical anesthesia,further application and promotion in clinical.