| 王 艳,张光明,李 煊,朱 明,冯 霞.喉上神经阻滞复合瑞芬太尼和右美托咪定用于经皮气管切开术的临床效果[J].现代生物医学进展英文版,2018,(12):2298-2301. |
| 喉上神经阻滞复合瑞芬太尼和右美托咪定用于经皮气管切开术的临床效果 |
| Efficacy of Superior Laryngeal Nerve Block Combined with Dexmedetomidine and Remifentanil for Percutaneous Tracheostomy |
| Received:September 22, 2017 Revised:October 15, 2017 |
| DOI：10.13241/j.cnki.pmb.2018.12.020 |
| 中文关键词: 经皮气管切开 喉上神经阻滞 瑞芬太尼 右美托咪定 |
| 英文关键词: Percutaneous tracheostomy Superior laryngeal nerve block Remifentanil Dexmedetomidine |
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| 中文摘要: |
| 摘要 目的：探讨喉上神经阻滞复合瑞芬太尼和右美托咪定应用于经皮气管切开术(PT)的临床效果。方法：将60例因呼吸困难行PT的患者随机分为两组。所有患者均喉上神经阻滞，对照组(30例)采用丙泊酚复合瑞芬太尼，实验组(30例)采用右美托咪定复合瑞芬太尼。观察并比较两组患者术前(T1)、麻醉药物注射结束后(T2)、气管切开置入套管时(T3) 、手术结束时(T4) 收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)及平均动脉压(MAP)、警觉/镇静(OAA/S)评分的变化及术中并发症的发生情况。结果：对照组T3、T4时刻SBP、DBP、HR、MAP均较T1时明显升高，且明显高于实验组同时点(P<0.05)，而实验组T2、T3、T4时SBP、DBP、HR、MAP与T1时刻比较差异无明显统计学意义(P>0.05)。实验组术中呛咳、呼吸抑制的发生率显著低于对照组(P<0.05)。两组T2~T4时刻OAA/S评分均明显低于T1时刻，且实验组OAA/S评分均明显低于对照组同时刻(P<0.05)。结论：喉上神经阻滞复合右美托咪啶和瑞舒芬太尼应用于PT中可维持血流动力学的稳定，减少应激反应，降低术中并发症的发生率。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical effect of superior laryngeal nerve block combined with dexmedetomidine and remifentanil for percutaneous tracheostomy (PT). Methods: 60 patients were scheduled for PT because of difficult breathing were ran- domly divided into two groups. All patients were performed by laryngeal nerve block, control group (n=30) was given with propofol combined with remifentanil, experimental group (n=30) was given with dexmedetomidine and remifentanil. The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood oxygen saturation (SpO2) and mean arterial pressure (MAP) before opera- tion(T1), after anesthetic injection (T2), tracheal incision and tracheostomy cannula placement (T3), at the end of the operation (T4) be- tween two groups were compared, and the intraoperative complications and observers assessment of alertness/sedation scale (OAA/S) score were observed and analyzed. Results: Compared with those at T1, the level of SBP, DBP, HR and MAP at T3, T4 in the control group were significantly elevated and higher than those in the experimental group (P<0.05), while there was no significant difference among T1 T2, T3, T4 in experimental group (P>0.05). The incidence of ntraoperative bucking, respiratory depression in experimental group was significantly lower than that in the control group (P<0.05). The OAA/S score at T2, T3, T4 in both groups were significantly reduced compared with those at T1, and experimental group had lower OAA/S score than that of the control group at the same time point (P<0.05). Conclusion: Superior laryngeal nerve block combined with dexmedetomidine and remifentanil can maintain the hemodynamic stability, reduce the stress response and the incidence of intraoperative complications for PT. |
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