常用快速序贯诱导药物不良反应防治的研究进展

Research Progress of Prevention and Treatment of Adverse Reactions during Rapid Sequence Induction

快速序贯诱导(RSI)在临床麻醉中应用广泛,尤其适用于合并反流/误吸风险患者的麻醉诱导,旨在快速完成气管插管、减少并发症、提高整体成功率。阿片类药物、依托咪酯和罗库溴铵是目前常用的RSI药物,但静脉推注时常伴随呛咳、肌阵挛和注射痛等不良反应,增加患者麻醉诱导风险。目前,上述药物不良反应相关作用机制尚不完全明确,因此有效防治其不良反应已成为国内外学者的研究重点,多种药物及非药物防治策略可有效降低不良反应发生率。未来深入探究药物不良反应机制及其临床合理应用对提高患者麻醉舒适度、保证麻醉安全具有重要意义。

Rapid sequential induction(RSI)is widely used in clinical anesthesia,especially for patients with reflux/aspiration risk.It aims to quickly complete endotracheal intubation,reduce complications and improve the overall success rate.Opioids,etomidate and rocuronium are currently commonly used representative drugs for RSI,but intravenous injection is often accompanied by adverse reactions such as cough,myoclonus and injection pain,which increases the risk of anesthesia induction in the patients.At present,the mechanism of the above adverse drug reactions is not completely clear,so the effective prevention and treatment of adverse reactions has become the research focus of the scholars at home and abroad.A variety of drug and non-drug prevention and treatment strategies can effectively reduce the incidence of adverse reactions.In the future,it is of great significance to further explore the mechanism of adverse drug reactions and their clinical rational application to improve the anesthesia comfort of the patients and ensure the anesthesia safety.