咪达唑仑联合羟考酮在烧伤困难气道患者纤维支气管镜插管中的应用效果

Effect of midazolam combined with oxycodone in fiberoptic bronchoscope intubation of burn patients with difficult airway

摘要:

目的 探究咪达唑仑联合羟考酮在烧伤困难气道患者纤维支气管镜插管中的应用效果。方法 选取2023年3月－2024年3月在该院就诊的，行纤维支气管镜插管的烧伤困难气道患者80例，根据麻醉用药不同，将患者分为对照组（40例，给予咪达唑仑麻醉）和联合组（40例，给予咪达唑仑联合羟考酮麻醉）。比较两组患者一次插管成功率、血流动力学指标［心率（HR）、平均动脉压（MAP）和经皮动脉血氧饱和度（SpO₂）］、Ramsay镇静评分和不良反应发生情况。结果 联合组一次插管成功率为95.00%，明显高于对照组的72.50%，差异有统计学意义（P < 0.05）；两组患者给药后（T₁）、插管1 min（T₂）和插管5 min（T₃）的HR和MAP较给药前（T₀）降低，且联合组HR明显低于对照组，MAP明显高于对照组，差异均有统计学意义（P < 0.05）；对照组T₁、T₂和T₃时点SpO₂明显低于T₀时点，联合组T₁和T₂时点SpO₂明显高于对照组，差异均有统计学意义（P < 0.05）；联合组T₂和T₃时点Ramsay镇静评分明显低于对照组，差异有统计学意义（P < 0.05）；联合组不良反应总发生率为12.50%，与对照组的7.50%比较，差异无统计学意义（P > 0.05）。结论 咪达唑仑联合羟考酮应用于烧伤困难气道患者纤维支气管镜插管，疗效好，一次插管成功率高，镇静效果更好，可维持血流动力学稳定，且用药安全性高。

Abstract:

Objective To explore the application effect of midazolam combined with oxycodone in fiberoptic bronchoscope intubation of burn patients with difficult airway.Methods 80 burn patients with difficult airway who underwent fiberoptic bronchoscope intubation from March 2023 to March 2024 were included as the study subjects. They were assigned into two groups based on anesthesia medication: the control group (40 cases) was given midazolam anesthesia, and the combined group (40 cases) was given midazolam combined with oxycodone anesthesia. The one-time success rate of intubation, hemodynamic indicators [heart rate (HR), mean arterial pressure (MAP), and percutaneous arterial oxygen saturation (SpO₂)], Ramsay sedation score, and adverse reactions were compared between the two groups.Results The success rate of intubation in the combined group (95.00%) was higher than that in the control group (72.50%), the difference was statistically significant (P < 0.05). The HR and MAP of both groups decreased after administration (T₁), 1 min after intubation (T₂), and 5 min after intubation (T₃) compared to before administration (T₀), and the HR of the combined group was lower than that of the control group, while the MAP was higher than that of the control group, the differences were statistically significant (P < 0.05). The SpO₂ at T₁, T₂ and T₃ time points in the control group was significantly lower than T₀ time point, the SpO₂ of the combined group was higher than that of the control group at T₁ and T₂ time points, the differences were statistically significant (P < 0.05); The Ramsay sedation score at T₂ and T₃ time points was lower than that of the control group, the difference was statistically significant (P < 0.05). The total incidence of adverse reactions in the combined group (12.50%) showed no obvious difference compared to the control group (7.50%) (P > 0.05).Conclusion The combination of midazolam and oxycodone has a good healing effect in fiberoptic bronchoscope intubation of burn patients with difficult airway, with a higher success rate of intubation, better sedation, and can maintain hemodynamic stability. It also has high medication safety.