右美托咪定喷鼻复合七氟烷在婴儿困难气道中的应用.DOCVIP

右美托咪定喷鼻复合七氟烷在婴儿困难气管插管中的应用 张明敏 樊雅玲 庞波 李元 葛佳 （四川省乐山市人民医院麻醉科，四川，乐山，614000） 【摘要】目的：评估右美托咪定喷鼻复合七氟烷在婴儿困难气道插管中应用的可行性及安全性。方法：选择40 例术前评估预测为困难气管插管的择期手术患儿，将其分为丙泊酚复合七氟烷组（A 组）和右美托咪定喷鼻复合七氟烷组（B 组）各20 例。测量两组患儿术前病房（T1）时的生命体征，收缩压、舒张压、HR、SPO2。A组患儿入室后静脉注射丙泊酚2mg/kg,后面罩下吸入七氟烷待下颌松弛后气管插管；B 组患儿术前右美托咪定喷鼻2ug/kg，待患儿入睡后入室，面罩吸入七氟烷，待下颌松弛后气管插管。记录两组患者入室时（T2）、麻醉诱导完成后（T3）以及气管插管时（T4）血压、心率（HR）、脉搏血氧饱和度（SpO2），一次性气管插管成功率、插管时间及气管插管的并发症、插管失败率、保留自主呼吸率。结果：T2时，A组心率高于B组；T3时A 组收缩压、舒张压、HR 均显著低于B 组，T4时A组收缩压、舒张压、HR均明显高于B组，且SPO2明显低于B组。结论：B组血流动力学更稳定，一次性气管插管成功率及插管时间、诱导中保留自主呼吸率均优于A组，B组插管并发症小于A组。右美托咪定喷鼻复合七氟烷用于小儿困难气道气管插管是一种相对安全、可靠的诱导方法。 关键词：右美托咪定喷鼻、婴儿、困难气道、麻醉 Dexmedetomidine given nasal spray composite sevoflurane on infants with difficult tracheal intubation Zhang Mingmin .Fan Yaling. Pang Bo.Li Yuan.Ge Jia (Leshan City, Sichuan Peoples Hospital, Department of Anesthesiology, Sichuan, Leshan, 614000) Abstract Objective:Evaluate dexmedetomidine given intranasally complex feasibility sevoflurane in infants difficult airway intubation and security applications .Methods: 40 patients with preoperative evaluation of children with elective surgery to predict difficult tracheal intubation, which was divided into propofol combined with sevoflurane group (A) and dexmedetomidine given intranasally composite sevoflurane group ( group B) 20 cases. Two groups of children before surgery ward (T1) measured vital signs when comparing SBP, DBP, HR, SPO2 no significant difference (P 0.05). A group of children with burglary after intravenous injection of propofol 2mg / kg, under the mask after sevoflurane be mandible after tracheal intubation; dexmedetomidine group B given nasal surgery in children, the children go to sleep until after burglary mask sevoflurane until jaw after tracheal intubation. When comparing the two groups were burglary (T2), after the completion of induction of anesthesia (T3) and intubation (T4) blood pressure, heart rate (HR), pulse oxygen saturation (SpO2), a one-time success rate of intubation, insertion tube int