镇静、镇痛慢诱导气管插管对全身麻醉患者血流动力学及心理影响

目的 探讨镇静镇痛慢诱导气管插管技术对减轻血流动力学波动,减少清醒气管插管对手术患者产生术后不良记忆、负面情绪、心理或精神影响.方法 选取昆明市第二人民医院2017年6月至2020年10月所收治的全身麻醉气管插管下非仰卧位手术患者116例,采用随机数字表法分为研究组和对照组,每组各58例,对照组患者给予常规快速诱导全麻...

The Clinical Study on the Effects of Sedation,Analgesia and Slow Induction of Endotracheal Intubation on Hemodynamics,Reduction of Postoperative Adverse Memory and Psycho- psychological Effects in Patients with General Anesthesia

  Objective   To investigate the effects of sedation and analgesia induced tracheal intubation on reducing hemodynamic fluctuation and conscious tracheal intubation on postoperative adverse memory, negative emotion, psychological or mental effects.  Methods   116 patients who were treated in our hospital from June 2017 to October 2020 were divided into the study group and the control group, with 58 cases in each group. The control group was given routine rapid induction of general anesthesia rapid induction of general anesthesia tracheal intubation, the medical staff completed posture placement, the study group was given sedation, analgesia, tracheal surface anesthesia slowly induced to lethargy and retained spontaneous breathing tracheal intubation. The hemodynamic indexes, postoperative memory and psychological status of the two groups were compared.  Results   There was no significant difference in the hemodynamic stability between the two groups T1 time points （P > 0.05）; the systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） hemodynamic stability of the study group was better than those of the control group （P < 0.05）. Of the two groups, the T3 time point systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） of the study group were better than those of the control group （0.05）, the systolic blood pressure （SBP）, diastolic blood pressure （DBP）, and heart rate （HR） of the study group were better than those of the control group （P < 0.05）. From the beginning of administration to the completion of tracheal intubation in the study group （P < 0.05）, At the end of operation, there was no significant difference between the two groups （P > 0.05）. There was no significant difference in memory and mental state between the two groups 1 d after operation （P > 0.05）.  Conclusion   Sedation, analgesia and slow induction of tracheal intubation in patients undergoing general anesthesia will not increase the probability of postoperative adverse memory, negative emotional, psychological or mental effects. The clinical operation time of slow induction is slightly longer than that of fast induction, but it will not cause the delay of awakening and extubation. Although the hemodynamic changes are caused by intubation, the effect is slight. Extubation can reduce the adverse reactions caused by extubation stimulation, and the hemodynamic effect is better than that of fast induced tracheal intubation.