【摘要】 目的观察羟考酮复合右美托咪定在清醒气管插管中的镇痛镇静效果以及对呼吸和循环功能的影响。方法选择术前预计困难气道的择期手术患者40例,随机分为舒芬太尼组和羟考酮组。两组患者静脉泵注右美托咪定1μg/kg后以0.2μg·kg^-1·h^-1维持,舒芬太尼组静注舒芬太尼0.2μg/kg,羟考酮组静注羟考酮0.08mg/kg。监测患者用药及插管期间HR、MAP和SpO₂变化,并记录插管前Ramsay评分以及插管后PETCO₂和舒适度评分。结果两组患者用药及插管期间的血流动力学变化、镇静及舒适度差异无统计学意义。羟考酮组患者静注后SpO₂明显高于舒芬太尼组（P<0.05）,气管插管后PETCO₂明显降低（P<0.05）。结论羟考酮复合右美托咪定可安全地用于清醒气管插管,镇痛、镇静效果良好,与舒芬太尼相比,呼吸抑制轻,不良反应少。更多还原

【Abstract】 Objective To observe the analgesic and sedative effects of oxycodone combined with dexmedetomidine and its effects on respiratory and cardiovascular functions during endotracheal intubation guided by fiberoptic bronchoscope at conscious state.Methods Forty patients with endotracheal intubation difficulty were randomly divided into sulfentanil group and oxycodone group.An initial induction dose of 1μg/kg dexmedetomidine was given followed by an maintaining infusion of 0.2μg·kg-1·h-1 in sulfentanil group,additionally,0.2μg/kg sulfentanil was given intravenously.Patients in oxycodone group received intravenous infusion of oxycodone 0.08mg/kg instead.The changes of HR,MAP and SpO2 were monitored during medication and intubation.The Ramsay scores before intubation,the PETCO2 and comfort degree after intubation were recorded.Results There were no statistically significant differences in hemodynamic changes,Ramsay scores and comfort level between the two groups during drug-injection and intubation.SpO2 of patients in oxycodone group was higher than that of sulfentanil group after injection of drugs,but PETCO2 of oxycodone group after endotracheal intubation was lower.Conclusion The combination of oxycodone and dexmedetomidine can be safely used in awake tracheal intubation,for it shows effective sedation and analgesia,less respiratory depression and other side-effects compared with sufentanil.更多还原