Abstract：Objective: To explore the application of different dosages of dexmedetomidine and propofol in tracheal intubation guided by fiberbronchoscope. Methods: From January 2017 to January 2019, 80 patients undergoing bronchofiberscope guided endotracheal intubation in our hospital were divided into four groups with 20 cases in each group according to the anesthesia dosage of dexmedetomidine and propofol. The hemodynamic indexes MAP, HR and SpO2 at T0, T1, T2, T3, T4 and T5 were compared between the two groups. Results: Repeated measurement analysis of variance showed that HR, SpO2, MAP time factors, time factors and group interaction were statistically significant (P<0.05); further comparison between the two groups showed that SpO2 value at T2, T3, T4 time was significantly lower than that at to time, map value at T2, T3, T4 time was significantly higher than that at to time; the fluctuation of HR, SpO2, MAP with time in group A was smaller than that in group B, group B was smaller than that in group C, and group C was smaller than that in group D, the difference was statistically significant (P<0.05). The success rate of intubation in group D (70.00%) was significantly lower than that in group A (95.00%) and group C (95.00%), the time of apnea in group C was significantly higher than that in group A, group B, group D, the time of intubation in group C was significantly lower than that in group A, group B, group D (P<0.05). The incidence of respiratory inhibition and bradycardia in group C was significantly higher than that in the other three groups, and the incidence of cough in group D was significantly higher than that in the other three groups (P<0.05). Conclusion: Different dosages of dexmedetomidine and different doses of propofol are safe and effective in fiberoptic bronchoscopy guided endotracheal intubation, and 1.0 μ g / kg dexmedetomidine and 0.8 mg / kg propofol are suitable for stabilizing hemodynamics, improving the success rate of intubation and reducing adverse reactions.
丛露, 王珊娟. 不同剂量右美托咪定与不同剂量丙泊酚在纤支镜引导气管插管中的应用比较[J]. 河北医学, 2020, 26(10): 1693-1697.
CONG Lu, WANG Shanjuan. Comparison of Different Dosages of Dexmedetomidine and Propofol in Fiberoptic Bronchoscopy Guided Endotracheal Intubation. HeBei Med, 2020, 26(10): 1693-1697.
[1] Avir Mitra. Confirmation of endotracheal tube placement using disposable fiberoptic bronchoscopy in the emergent setting[J]. World Journal of Emergency Medicine, 2019, 10(4):210. [2] Alfredo González-Gil, Rosa Ana Picazo, Paul de Bruyn,et al. Corticoadrenal and cardiorespiratory responses to administration of propofol combined with dexmedetomidine or ketamine in rabbits[J]. Journal of the American Association for Laboratory Animal Science Jaalas, 2018, 57(3):278~281. [3] Avir Mitra. Confirmation of endotracheal tube placement using disposable fiberoptic bronchoscopy in the emergent setting[J]. World Journal of Emergency Medicine, 2019, 10(4):210. [4] 贺争光,赵博,孙晨旭,等.丙泊酚与瑞芬太尼在成人纤维支气管镜检麻醉中的合适配比探讨[J].中国医师杂志,2018,20(4):496~498. [5] 梅弘勋,熊蔚,韩如泉.右美托咪定在颅脑手术麻醉中的应用[J].中国医药,2017,12(3):370~374. [6] 朱玉梅.右美托咪定联合小剂量丙泊酚麻醉诱导对老年全麻患者气管插管应激反应的影响[J].江苏医药,2018,44(5):543~545. [7] 黄文锋.右美托咪定复合小剂量丙泊酚用于无痛纤维支气管镜检查的有效性及安全性[J].山西医药杂志,2019,48(2):152~154. [8] 李芬,党炳文,霍建臻.瑞芬太尼复合小剂量右美托咪定用于清醒气管插管的效果分析及对血流动力学指标的影响[J].河北医学,2017,23(10):1738~1741. [9] 周海燕,沈琴,宋铖.不同剂量右美托咪定复合丙泊酚联合瑞芬太尼在无痛支气管镜检查中的效果[J].浙江医学,2019,41(19):2110~2113.
2020, Vol. 26 
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