ICU患者气管插管的心血管应激反应与不同麻醉手段相关性

摘要

Objective To compare the effect of different anesthesia methods used in the tracheal intubation on ICU patients,and to observe the cardiovascular responses in order to find out the best mehtod of anesthesia. Methods 60 ICU patients in our hospital were randomly divided into observation group and control group.The observation group were treated with fentanyl(5μg/kg),propofol(1.5mg/kg),vecuronium(0.1mg/kg)and ketamine(1mg/kg);the control group were treated with fentanyl(5μg/kg),propofol(1.5mg/kg),vecuronium(0.1mg/kg) and midazolam (0.1mg/kg).The hemodynamic fluctuations before and after anesthesia between the two groups were observed. Results The blood pressure and heart rate in the two groups changed obviously after tracheal intubation compared with pre anesthesia. The difference was statistically significant(P<0.05).The amplitude of fluctuation of blood pressure,heart rate in the observation group is significantly lower than that of the control group,the difference was statistically significant (P<0.05). Conclusion The method of the tracheal intubation anesthesia using Katarina combined with protocol and fontanel has good effect and high safety.It is worth applicating in clinic work.%目的：对比不同麻醉方法应用于ICU患者气管插管的效果，观察心血管应激反应，探寻最佳麻醉疗法。方法选取我院治疗的60例ICU患者为研究对象，随机分为观察组与对照组，均采用气管插管诱导，静脉麻醉。观察组予5μg/kg芬太尼、1.5mg/kg丙泊酚、0.1mg/kg维库溴铵、1mg/kg氯胺酮联合使用；对照组予5μg/kg芬太尼、1.5mg/kg丙泊酚、0.1mg/kg维库溴铵、0.1mg/kg咪达唑仑联合使用，对比观察两组麻醉前后血液动力学变化。结果与麻醉前相比，观察组与对照组气管插管麻醉诱导后血压、心率均有明显改变，其差异有统计学意义（P＜0.05）。观察组血压、心率波动幅度明显小于对照组，其差异有统计学意义（ P＜0.05）。结论氯胺酮联合丙泊酚、芬太尼应用于气管插管麻醉诱导患者，效果显著，安全性高，具有临床应用价值。