Abstract:Objective To explore the application effect of different sedation methods in awake tracheal intubation under the visible soft laryngoscope.Methods Forty patients with difficult airway who underwent elective surgery under intubation general anesthesia from January 2018 to January 2019 in our hospital were enrolled.The patients underwent awake tracheal intubation under the visible soft laryngoscope,and were divided into Dexmedetomidine group(n=20)and Midazolam group(n=20)according to different sedation methods.Patients in the Dexmedetomidine group were sedated with Dexmedetomidine,and patients in the Midazolam group were sedated with Midazolam.The mean arterial pressure(MAP),heart rate(HR),oxygen saturation(SpO2),and respiratory rate(RR)at 10minutes after admission(T0),10minutes(T1)after medication,immediate after successful intubation(T2),and 10minutes after intubation(T3)were observed.The total intubation time,the total incidence rate of adverse reactions,and the success rate of one intubation were compared between the two groups of patients.Results At T0,there were no significant differences in MAP,HR,SpO2 and RR between the two groups(P>0.05).At T1,the differences in MAP,HR,SpO2,and RR between the two groups were statistically significant(P<0.05).The MAP,HR,SpO2,and RR at T1 in the Midazolam group were lower than those at T0,and the MAP and HR in the Dexmedetomidine group at T1 were lower than those at T0,with statistically significant differences(P<0.05).There were no significant differences in SpO2 and RR between T1 and T0 in the Dexmedetomidine group(P>0.05).At T2,the differences in MAP,HR,SpO2,and RR between the two groups were statistically significant(P<0.05).In the Dexmedetomidine group,the MAP and HR at T2 were lower than those at T0,and the differences were statistically significant(P<0.05).There were no significant differences in SpO2 and RR between T2 and T0 in the Dexmedetomidine group(P>0.05).There were no significant differences in MAP and HR between T2 and T0 in the Midazolam group(P>0.05).There were statistically significant differences in SpO2,RR between T2 and T0 in the Midazolam group(P<0.05).At T3,there were no significant differences in MAP,HR,and SpO2 between the two groups(P>0.05).There were statistically significant differences in MAP and HR between T3 and T0 in the two groups(P<0.05).There was no significant difference in SpO2 between T3 and T0 in the two groups(P>0.05).The total intubation time in the Dexmedetomidine group was shorter than that in the Midazolam group,and the difference was statistically significant(P<0.05).The total incidence rate of adverse reactions in the Dexmedetomidine group was lower than that in the Midazolam group,with significant difference(P<0.05).The success rate of one intubation in the Dexmedetomidine group was higher than that in the Midazolam group,and the difference was statistically significant(P<0.05).Conclusion Compared with Midazolam,Dexmedetomidine has great advantages and effect in awake tracheal intubation under visual soft laryngoscope,which can not only reduce the intubation stress response,but also has a stable hemodynamic level.It can reduce the incidence of adverse reactions and is worthy of clinical promotion.
赖尚导; 陈伟元; 叶阮昊; 彭宗海; 孙勉盛. 不同镇静方式在可视软镜下清醒气管插管中的应用[J]. 中国当代医药, 2020, 27(4): 162-165转169.
LAI Shang-dao; CHEN Wei-yuan; YE Ruan-hao; PENG Zong-hai; SUN Mian-sheng. Application of different sedation methods in awake tracheal intubation under the visible soft laryngoscope. 中国当代医药, 2020, 27(4): 162-165转169.