芬太尼使用与输管后平均动脉压在快速序列输管过程中的关联:前性观察性研究
Abdullah Bakhsh1, Ahmad Bakhribah1, Raghad Alshehri2
1Department of Emergency Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
The western journal of emergency medicine
|February 7, 2025
概括
在快速序列输管 (RSI) 期间用静脉注射芬太尼的预治疗与平均动脉压 (MAP) 的更大降低有关. 建议在RSI中使用芬太尼的剂量和理由要小心谨慎,以防止并发症.
科学领域:
- 紧急医疗 紧急医疗
- 麻醉学 麻醉学
- 关键的护理关键的护理
背景情况:
- 快速序列输管 (RSI) 是紧急医学的关键程序.
- 对RSI的药物选择显著影响患者的血液动力学稳定性和结果.
- 插管期间心脏骤停是一种致命的并发症,低氧或低血压患者的风险增加.
研究的目的:
- 调查芬太尼前期治疗与RSI期间平均动脉压 (MAP) 变化之间的关联.
- 为了评估50微克静脉注射芬太尼剂量对诱导后血液动力学参数的影响.
主要方法:
- 对278名在学术急诊室接受RSI的患者进行前性观察性研究.
- 包括MAP在内的血液动力学参数在诱导前和10分钟后被测量.
- 患者被分为芬太尼和非芬太尼组进行分析,并对混因子进行后勤回归.
主要成果:
- 与非芬太尼尔组 (3.2%) 相比,芬太尼尔组的MAP下降幅度显著更大 (12.7%).
- 经过对混因子进行调整后,芬太尼使用 (50微克静脉注射) 将MAP降低至少10%的可能性增加了2.14倍.
- 第一次通过成功率在各组之间没有显著差异.
结论:
- 使用50μg静脉注射芬太尼作为RSI的预治疗剂与显著的MAP减少的可能性更高有关.
- 临床医生应仔细考虑芬太尼的剂量,并证明其在RSI中的使用是合理的,以减轻潜在的血液动力学并发症.
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