羟考酮复合右美托咪定对清醒气管插管患者术中呼吸及循环功能的影响

目的]探讨羟考酮复合右美托咪定对清醒气管插管患者术中呼吸及循环功能的影响.方法]预计困难气道的择期手术患者82例均分为两组,各41例,患者均在清醒状态下气道插管,对照组患者给予舒芬太尼复合右美托咪定麻醉诱导,观察组给予羟考酮复合右美托咪定麻醉诱导.比较不同时间点两组患者收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)等循环系统参数以及气道压力(PAW)、呼气末二氧化碳分压(PETCO2)等呼吸功能指标水平变化,比较两组插管前镇静(Ramsay)、插管后舒适度评分及不良反应发生率.结果]观察组患者诱导后1 min、5 min时SBP、DBP、MAP、HR水平与对照组比较显著增高(P<0.05).插管后1 min时MAP水平较对照组高(P<0.05).插入后3 min、拔除即刻对照组PAW、PETCO2水平显著高于观察组(P<0.05).观察组患者不良反应总发生率为9.76%(4/41)明显低于对照组29.27%(12/41)(P<0.05).结论]羟考酮复合右美托咪定能安全的应用于清醒气管插管患者中,对患者的呼吸和循环功能影响较小,镇痛镇静效果良好,不良反应发生率低,值得临床应用推广.

Effects of Oxycodone Combined with Dexmedetomidine on Intraoperative Respiratory and Circulatory Function in Patients Undergoing Awake Tracheal Intubation

Objective]To study the effects of oxycodone combined with dexmedetomidine on intraoperative respiratory and circulatory functions in patients undergoing awake tracheal intubation.Methods]Eighty-two patients who received elective operation for difficult airway were divided into two groups with 41 cases in each group.The control group was given sufentanil combined with dexmedetomidine anesthesia,while the observation group was given oxycodone combined with dexmedetomidine anesthesia.The changes of circulatory system parameters and respiratory function indices were compared between the two groups at different time points.The sedation score (Ramsay) before intubation,comfort score after intubation,and the incidence of adverse reactions were compared between the two groups.Results]The levels of SBP,DBP,MAP,and HR in the observation group were significantly higher than those in the control group at 1 min and 5 min after induction (P<0.05).The level of MAP was significantly higher than that in the control group 1 min after intubation (P<0.05).At 3 min after intubation and at the time of intubation removal,the levels of PAW and PETCO2 in the control group were higher than those in the observation group (P<0.05).The total incidence of adverse reactions in the observation group,9.76%,was significantly lower than that in the control group,29.27% (P<0.05).Conclusion]The application of oxycodone combined with dexmedetomidine is safe in patients undergoing awake tracheal intubation.Its analgesic and sedative effects are good.It has little effect on respiratory function and circulatory function and has a low incidence of adverse reactions.