右美托咪定对OSAS纤支镜引导下经鼻气管插管患者血流动力学及插管效果的影响

Effects of dexmedetomidine on hemodynamics and intubation effect in obstructive sleep apnea syndrome patients undergoing transnasal endotracheal intubation guided by fiberbronchoscope

目的探讨右美托咪定在阻塞性睡眠呼吸暂停综合征(OSAS)纤支镜引导下经鼻气管插管患者中的应用效果。方法将我院收治的110例OSAS患者随机分为对照组和研究组,各55例。对照组与研究组患者分别辅助舒芬太尼与右美托咪定行表面麻醉,后于纤支镜引导下经鼻气管插管。比较两组患者的麻醉效果。结果窥视会厌(T_(1))~气管插管后3 min(T_(3))时,研究组的平均动脉压(MAP)、心率(HR)均低于对照组,血氧饱和度(SpO_(2))高于对照组(P<0.05);气管插管成功即刻(T_(2))、T_(3)时,研究组的Ramsay评分高于对照组(P<0.05)。研究组的气道阻塞评分、术后插管记忆评分低于对照组,插管时耐受评分高于对照组,插管成功时间短于对照组(P<0.05)。研究组的各类不良事件发生率均低于对照组(P<0.05)。结论相较于舒芬太尼,右美托咪定在OSAS患者纤支镜引导下经鼻气管插管麻醉中具有较高的应用价值。

Objective To investigate the application effect of dexmedetomidine in obstructive sleep apnea syndrome(OSAS)patients undergoing transnasal endotracheal intubation guided by fiberbronchoscope.Methods A total of 110 OSAS patients admitted in our hospital were randomly divided into control group and study group,with 55 cases in each group.The patients in the control group and the study group were assisted with sufentanil and dexmedetomidine for topical anesthesia respectively,and then were given transnasal endotracheal intubation guided by fiberbronchoscope later.The anesthetic effects of the two groups were compared.Results At spying epiglottis(T_(1))~3 min after endotracheal intubation(T_(3)),the mean arterial pressure(MAP)and heart rate(HR)of the study group were lower than those of the control group,while oxygen saturation of blood(SpO_(2))was higher than that of the control group(P<0.05);at immediately after endotracheal intubation(T_(2))and T_(3),the Ramsay score of the study group was higher than that of the control group(P<0.05).The airway obstruction score and postoperative intubation memory score of the study group were lower than those of the control group,the tolerance score during intubation was higher than that of the control group,and the time of successful intubation was shorter than that of the control group(P<0.05).The incidences of various adverse events in the study group were lower than those in the control group(P<0.05).Conclusion Compared with sufentanil,dexmedetomidine has higher application value in the anesthesia of transnasal endotracheal intubation guided by fiberbronchoscope for OSAS patients.