舒芬太尼复合咪达唑仑和异丙酚用于小儿无肌松药气管插管的研究

发布时间：2018-03-30 04:03

本文选题：舒芬太尼　切入点：咪达唑仑　出处：《东南大学学报(医学版)》2017年02期

【摘要】：目的:研究舒芬太尼复合咪达唑仑和异丙酚用于小儿无肌松药气管插管的临床价值。方法:将我院93例短小手术无肌松药气管插管患儿抽签随机分为A、B、C 3组,每组31例,均行舒芬太尼加咪达唑仑加异丙酚诱导麻醉,舒芬太尼分别给予0.3、0.4、0.5μg·kg~(-1)3种剂量,以Viby-Mogensen评分评价3组气管插管情况并记录成功率,同时记录基础值、麻醉诱导后(T0)、气管插管即刻(T1)、气管插管后1 min(T2)、气管插管后3 min(T3)、气管插管后5 min(T4)时心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)变化,分组记录术后2、4、8、12、24 h镇静评分及疼痛评分,同时观察不良反应发生率。结果:3组均全部完成插管,插管成功率100%。C组气管插管效果较好,但各组比较差异无统计学意义(P0.05);3组患儿于气管插管即刻均见HR、MAP、DBP、SBP增高,与其他时间比较差异有统计学意义(P0.05),同时点各水平呈C→B→A组递增趋势;术后疼痛程度以C组最轻,但3组组间比较差异无统计学意义(P0.05),3组术后Ramsay评分比较差异均无统计学意义(P0.05);3组不良反应发生率比较差异无统计学意义(P0.05)。结论:舒芬太尼复合咪达唑仑和异丙酚可满足小儿无肌松药气管插管的麻醉要求,舒芬太尼剂量与气管插管时心血管反应呈剂量依赖性,舒芬太尼0.4μg·kg~(-1)剂量可良好抑制不良应激,保证气管插管效果,并无明显不良反应出现,可作为优选方案。
[Abstract]:Objective: to study the clinical value of sufentanil combined with midazolam and propofol for tracheal intubation in children without muscle relaxant.Methods: 93 children with tracheal intubation without muscle relaxant in our hospital were randomly divided into three groups: group C (n = 31). Sufentanil plus midazolam plus propofol was used to induce anesthesia. Sufentanil was given 0. 3 渭 g / 0. 4 渭 g / g of sufentanil.The tracheal intubation was evaluated with Viby-Mogensen score and the success rate was recorded.After anesthesia induction, T0, T1, T2, T3, T3, T4, SBP, DBP, MAPP were observed. The scores of sedation and pain were recorded at 24 hours after intubation.At the same time, the incidence of adverse reactions was observed.Results the intubation was completed in all of the three groups. The intubation success rate in group 100 was better than that in group C, but there was no significant difference among the three groups (P 0.05). The DBPSBP of HRP MAPP was increased immediately after tracheal intubation.Compared with other time, the difference was statistically significant (P 0.05). At the same time, there was an increasing trend of each level in group C, and the degree of postoperative pain in group C was the least.However, there was no significant difference in Ramsay scores among the three groups. There was no significant difference in the incidence of adverse reactions among the three groups. There was no significant difference in the incidence of adverse reactions in the three groups.Conclusion: sufentanil combined with midazolam and propofol can meet the anesthesia requirements of tracheal intubation without muscle relaxant in children. The dose of sufentanil is in a dose-dependent manner with cardiovascular response to tracheal intubation. Sufentanil (0.4 渭 g 路kg ~ (-1)) can well inhibit adverse stress.To ensure the tracheal intubation effect, there is no obvious adverse reaction, which can be used as the optimal scheme.
【作者单位】：上海交通大学医学院附属第九人民医院麻醉科;上海交通大学医学院附属瑞金医院麻醉科;
【基金】：国家自然科学基金青年科学基金项目(30901410)
【分类号】：R726.1

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