Application value of dexmedetomidine combined with different doses of sufentanil in awake nasal intubation on elderly patients / 中国基层医药

ABSTRACT

Objective To observe the application value of dexmedetomidine combined with different doses of sufentanil in clear tracheal intubation on elderly patients.Methods From October 2014 to September 2016,42 elderly patients with difficult trachea in the People's Hospital of Taierzhuang District were selected and divided into observation group 1,observation group 2 and observation group 3 according to the random table method,with 14 cases in each group.The patients in three groups were intravenously given the same dose of dexmedetomidine injection,and on this basis,the three groups were intravenously given different doses of sufentanil injection.The one-time intubation success rate and the mean arterial pressure(MAP),heart rate(HR),electrocardiogram(ECG),blood oxygen saturation(SpO2),end-tidal carbon dioxide monitoring(PETCO2),and Ramsay sedation score before intubation,immediately after intubation,5min after intubation and immediately after extubation were compared.Results The one-time intubation success rates of the observation group 1,group 2 and group 3 were 64.29％,71.43％and 57.14％,respectively,and there was no statistically significant difference among the three groups(P>0.05).Immediately after intubation,the MAP of the observation group 1,group 2 and group 3 were(84.62 ±5.03)mmHg,(98.97 ±6.20)mmHg and(82.92 ± 5.10)mmHg,HR were(67.94 ±2.85)times/min,(69.89 ±3.55)times/min and(66.47 ±4.22)times/min,respectively,SpO2 were(94.17 ±5.14)％,(97.45 ±3.87)％and(92.84 ±5.30)％,respectively,which were all decreased significantly compared with those before intubation(t=6.098,1.831,6.719,4.188,2.139,4.748,2.705,1.752,3.720,all P<0.05).At 5min after intubation,the MAP of the observation group 1,group 2 and group 3 were(83.94 ±3.81)mmHg,(97.87 ±3.34)mmHg and(81.87 ±3.70)mmHg,respectively,HR were(66.38 ± 3.05)times/min,(68.80 ±3.92)times/min and(65.37 ±4.48)times/min,respectively,SpO2 were(92.81 ± 5.53)％,(96.95 ±4.90)％and(90.17 ±4.51)％,respectively,which were all decreased significantly compared with before intubation(t=6.601,2.410,7.402,4.432,2.736,5.236,3.294,1.911,5.660,all P <0.05).The Ramsay sedation score of the observation group 2 was(3.16 ±0.36)points,which was higher than(1.78 ±0.29)points of the observation group 1(t=8.716,P=0.000),but lower than(5.03 ±0.72)points of the observation group 3(t=5.503,P=0.000).Conclusion Dexmedetomidine combined with 0.25μg/kg sufentanil in awake nasal intubation on elderly patients has the least effect on vital signs and hemodynamics,and the sedation depth is moderate.