摘要
目的探讨靶控输注瑞芬太尼(REM)在纤维支气管镜(纤支镜)清醒气管插管中应用的临床价值。方法40例困难插管患者随机均分F组、R组,各20例。表麻后,F组静脉缓注芬太尼2μg/kg,R组泵注REM2ng/ml血浆靶控浓度,3min后纤支镜气管插管。结果(1)血流动力学变化R组患者SBP、HR稳定(P>0.05),F组患者则表现为显著的SBP升高、HR加快(P<0.01)。(2)静息肺功能变化R组患者各时段均表现为RR、VT显著下降(P<0.01),两组患者脉搏血氧饱和度、呼气末二氧化碳各时段与麻醉前比较差异无统计学意义(P>0.05)。(3)R组插管条件、镇静效果优于F组(P<0.01),R组插管心血管反应发生率(25%)低于F组(65%)。结论输注瑞芬太尼2ng/ml血浆靶控浓度辅助表麻下纤支镜气管插管,效果良好,心血管反应少。
Objective To investigate the effect and clinical valve of target-controlled infusion of remifentanil for conscious intubation of patients under fibrobronchoscopy. Methods Forty patients were randomly divided into two groups（F and R）,each group contained 20 cases. All of the patients were intubated on regional anaesthesia, as the first step, then the patients in F group were given fentanyl 2μg/kg by vein. In remifentanil target-controlled infusion group （R group）, the patients were kept infusing remifentanil 2ng/ml. Results （1）Haemodynamics： in R group,SBP and HR kept steadily; In F group, while the two indices increased significantly. （2）Static pulmonary function ; in R group, RR, VT deceased remarkablely. There were no difference between two groups in SpO2 and PET CO2. （3）Tracheal intubating condition and Ramsay score in R group were better than in F group;Cardiovascular response in R group was lower. Conclusion Target-controlled infusion of remifentanil for conscious intubation can achieve excellent result, with less cardiovascular response.
出处
《中国基层医药》
CAS
2006年第4期586-587,共2页
Chinese Journal of Primary Medicine and Pharmacy
关键词
瑞芬太尼
输注泵
插管法
气管内
芬太尼
Remifentanil
Infusion pumps
Intubation,intratracheal
Fentanyl
