摘要
目的探讨七氟醚、瑞芬太尼与丙泊酚用于保留自主呼吸困难气道的临床价值。方法选择麻醉预计困难气道病人80例,随机分为2组,各40例。观察组使用七氟醚、瑞芬太尼与丙泊酚,对照组使用丙泊酚联合咪达唑仑进行麻醉诱导。比较两组插管前后平均动脉压、心率、脑电双频指数（BIS）变化,统计两组插管时应激反应及插管成功率。结果对照组插管后平均动脉压和BIS高于插管前（t=10.660、17.412,P〈0.05）,心率快于插管前（t=18.632,P〈0.05）。插管后观察组平均动脉压和BIS低于对照组（t=11.334,F=8.302,P〈0.05）,心率慢于对照组（t=17.468,P〈0.05）。观察组插管时出现下颌紧张、声门紧闭、呛咳和肢体活动的比例显著低于对照组（χ2=5.600~7.941,P〈0.05）,1次插管成功率显著高于对照组（χ2=7.218,P〈0.05）。结论保留自主呼吸的气管插管,应用七氟醚、丙泊酚与瑞芬太尼进行麻醉诱导,能够创造良好的气管插管条件。
Objective To assess the value of sevoflurane,remifentanil and propofol for difficult airway patients undergoing spontaneous breathing anesthesia. Methods Eighty patients anticipated with difficult airway to intubate were divided into two groups as observation and control in random with 40 in each group.Patients in the observation group received sevoflurane,remifentanil or propofol,those in the control group received propofol combined with midazolam for anesthesia induction.The mean arterial pressure,heart rate,and bispectral index（BIS）-before and after intubation-were compared between the two groups.Stress response at intubation and its success rate were recorded. Results The mean arterial pressure and BIS in the control group after intubation were higher than before（t=10.660,17.412;P〈0.05）,and heart rate was faster（t=18.632,P〈0.05）.The mean arterial pressure and BIS in the observation group after intubation were lower than that in the control group（t=11.334,F=8.302,P〈0.05）,and heart rate was slower（t=17.468,P〈0.05）.The ratio of jaw tension,closure of the glottis,bucking and limb movement at intubation was lower in the observation group than that in the control（χ2=5.600-7.941,P〈0.05）,and one-intubation success rate was higher（χ2=7.218,P〈0.05）. Conclusion Using sevoflurane,remifentanil and propofol for anesthesia induction can create satisfactory conditions for tracheal intubation in patients with difficult airway under spontaneous breathing.
出处
《齐鲁医学杂志》
2016年第1期36-38,共3页
Medical Journal of Qilu
关键词
麻醉
七氟醚
瑞芬太尼
二异丙酚
呼吸
困难气道
anesthesia
sevoflurane
remifentanil
propofol
respiration
difficult airway
