两种镇静镇痛方法在抢救性气管插管的对比研究

doi:10.3969/j.issn.1006-6233.2021.01.038

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Abstract Objective: To study the efficacy and safety of sufentanil combined with midazolam to induce sedation and analgesia to substitute fentanyl combined with midazolam. Methods: A total of 80 patients admitted to the Department of Intensive Medicine of our hospital for tracheal intubation due to various reasons were selected from January 1, 2019 to June 30, 2020. The grouping method was simple random grouping, and they were divided into sufentanil group and fentanyl group (40 cases in each). Sufentanil group used sufentanil 0.25-0.5μg / kg + midazolam 0.025-0.05mg / kg before intravenous intubation; Fentanyl group used before intubation Tani 0.5-1μg / kg + midazolam 0.025~0.05mg / kg; 4-5min after administration of the drug, tracheal intubation was conducted immediately. The blood pressure, heart rate, oxygen saturation, and respiratory rate of the two groups of patients were recorded before intubation, during intubation, and after intubation; at the same time, the reverse inhalation, apnea, arrhythmia, and intubation success during intubation were monitored. The required number of times, the success rate of one-time intubation, the incidence of choking cough during the induction period of general anesthesia and the serious situation were monitored. Results: In the fentanyl group and the sufentanil group, the differences in the mean arterial pressure, respiratory rate, blood oxygen saturation, and heart rate were statistically significant (all P<0.001), the patient's basic data, before and after intubation data showed statistically significant difference (all P<0.001), and there were interactions between different groups and time, the differences between the two groups at the same time point were statistically significant (all P<0.001). The same group at different time points within the period, the mean arterial pressure and blood oxygen saturation gradually increased, and the respiratory rate and heart rate gradually decreased (all P<0.001). Sufentanil group had lower incidence of reflux aspiration, apnea, and arrhythmia than fentanyl group (P <0.05). Sufentanil group required less successful intubation than the fentntanyl group (P <0.05). The degree of choking in sufentanil group was better than that in the fentanyl group (P <0.05).Conclusion: Sufentanil combined with midazolam is safer and more reliable than fentanyl combined with midazolam.

Key words： Sufentanil Midazolam Fentanyl Sedation and analgesia induction Feasibility Safety

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.01.038 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I1/163