摘要
目的观察舒芬太尼在纤维光导喉镜引导经鼻清醒气管插管中的镇痛、镇静效果以及对呼吸和循环功能的影响。方法30例困难气管插管患者随机分为舒芬太尼+氟哌利多组(S组,n=15)和芬太尼+氟哌利多组(F组,n=15)。所有患者均以1%丁卡因表面麻醉后纤维光导喉镜引导经鼻清醒气管插管,于用药前(T0)、用药后5min(T1)和气管插管后即刻(T2),记录呼吸和循环功能参数、疼痛VAS评分、镇静Ramsay评分等。结果所有病例均顺利完成经鼻气管内插管。S组镇痛(VAS:0.3±0.2)和镇静(Ramsay:3.1±1.2)程度均优于F组(1.5±1.1和2.2±1.1)(P<0.01)。和T0比较,2组患者T1时RR、MV、SpO2、HR和RPP均显著下降(P<0.01),F组T2时SBP和RPP高于T0且同时也高于S组(P<0.01)。结论舒芬太尼用于纤维光导喉镜引导经鼻清醒气管插管时镇痛、镇静满意,效果优于芬太尼。舒芬太尼或芬太尼和氟哌利多复合用药对呼吸和循环有一定抑制作用。
Objective To observe the analgesic and sedative effects of sulfentanil and its effects on respiratory and cardiovascular functions during nasotracheal fibroptic endocracheal intubation at conscious state. Methods 30 patients who were difficult to perform endotracheal intubation were randomly divided into group S （sulfentanil 0.2μg/kg ＋ droperidol 2.5mg, n=15） and group F （fentanyl 21μg/kg ＋ droperidol 2.Stag, n=15）. After surface anesthesia with 1% tetracaine hydrochloride, nasotracbeal fibroptic endocracbeal intubation at conscious state was performed. RR, MV, SpO2, HR and RPP were detected before injection of drug （T0）; 5 rain after injection of drug （T1） and after intubation （T2）. Results Nasotracbeal intubation was successfully finished in all patients. The analgesic and sedative effects in group S （VAS： 0.3 ± 0.2; Ramsay： 3.1±1.2） were better than those in group F （VAS： 1.5 ± 1.1; Ramsay： 2.2 ± 1.1 ） （P〈0.01）. Comparing to To （before injection of drug） , RR, MV, SpO2, HR and RPP of all patients were significantly decreased in T1 （5 minutes after injection of drugs）. And SBP, RPP of Group F after intubation （T2） is higher than before injection of drug （To）, and also higher than Group S （P〈0.01）. Condusions The analgesic and sedative effects of sulfentanil are satisfactory and better than fentanyl during nasotracbeal fibroptic endocracbeal intubation at conscious state.Sulfentanil or fentanyl combined with droperidol has inhibitory effect on respiratory and cardiovascular functions.
出处
《海南医学》
CAS
2007年第9期23-24,12,共3页
Hainan Medical Journal
