右美托咪定联合羟考酮对纤维支气管镜插管患者镇静作用研究

Research on the sedative effect of the sedative effect of the patient's sedative of the fiber trifle with hydroxylk ketone

目的探讨右美托咪定联合羟考酮对纤维支气管镜插管患者的镇静作用。方法选取2016年9月至2018年9月在台州市第一人民医院行纤维支气管镜插管的患者92例,采用数表法随机分为对照组和研究组,每组各46例。对照组患者静脉滴注舒芬太尼0.1μg/kg和右美托咪定1.0μg/kg,研究组患者静脉滴注羟考酮0.10mg/kg和右美托咪定1.0μg/kg。比较两组患者进入手术室情况稳定时(T0)、麻醉5min后(T1)、患者麻醉药物输注完成即刻(T2)、患者插管完成即刻(T3)各时间段的Ramsay镇静评分和血流动力学相关指标检查,以及插管状况、并发症、术中知晓发生率。结果两组患者T0、T1时间段Ramsay镇静评分比较,差异无统计学意义(P>0.05),T2、T3时间段Ramsay镇静评分比较,差异有统计学意义(P<0.05),且T2、T3时间段研究组的Ramsay镇静评分高于对照组,差异有统计学意义(P<0.05)。比较两组患者在T0、T1时间段的心率、有创平均动脉压、收缩压及舒张压,差异均无统计学意义(P>0.05),T2时间段时研究组的心率、有创平均动脉压、收缩压及舒张压高于对照组,T3时间段时研究组低于对照组,差异均有统计学意义(P<0.05)。比较两组患者在各时间段的血氧饱和度,差异无统计学意义(P>0.05)。研究组患者的插管评分、完成插管时间、并发症发生率、术中知晓发生率均显著低于对照组,一次性插管成功率明显高于对照组,差异均有统计学意义(P<0.05)。结论右美托咪定联合羟考酮对纤维支气管镜插管患者镇静效果显著,可维持患者血流动力学稳定,提高一次性插管成功率,降低患者并发症和术中知晓发生率。

Objective To study the sedative effect of dexmedetomidine combined with oxycodone in patients with fiberoptic bronchoscopy intubation.Methods According to the random number expression method,a total of 92 patients with fiberoptic bronchoscopy intubation who were treated in Taizhou First people's Hospital from September 2016 to September 2018 were selected and divided into the control group and the study group,with 46 cases in each group.According to the clinical symptoms of different patients,anesthesiologists will formulate different anesthesia methods according to the type of surgery.The control group received intravenous injection of sufentanil 0.1μg/kg and dexmedetomidine 1.0μg/kg,and the study group received intravenous injection of oxycodone 0.10mg/kg and dexmedetomidine 1.0μg/kg.The Ramsay sedation score,hemodynamics,and hemodynamics were calculated when the patients in the two groups entered the operating room in a stable condition(T0),after 5 minutes of anesthesia(T1),immediately after the infusion of anesthetic drugs(T2),and immediately after intubation(T3).The related indicators were checked,and the intubation status,complications,and the incidence of intraoperative awareness were counted.Results The comparison of Ramsay sedation scores between the two groups at T0 and T1 time periods,the differences were not statistically significant(P>0.05),the comparison of Ramsay sedation scores at T2 and T3 time periods between the two groups,the differences were statistically significant(P<0.05),and the Ramsay sedation scores of the study group at T2 and T3 time periods were higher than those of the control group,the differences were statistically significant(P<0.05).There was no significant difference in heart rate,mean arterial pressure,systolic blood pressure and diastolic blood pressure between the two groups at T0 and T1 time periods(P>0.05),and in the T3 time period,the study group was lower than those in control group,and the differences were statistically significant(P<0.05).There was no significant difference in blood oxygen saturation between the two groups of patients at each time period(P>0.05).The intubation score,the completion time of intubation,the incidence of complications and the incidence of intraoperative awareness in the study group were significantly lower than those in the control group,and the success rate of one-time intubation was significantly higher than that in the control group,with statistical significance(P<0.05).Conclusion Dexmedetomidine combined with oxycodone has a significant sedative effect on patients with fiberoptic bronchoscopy intubation,can maintain the patient's hemodynamic stability,improve the success rate of one-time intubation,and reduce the incidence of complications and intraoperative awareness.