Nursing of sedation and analgesia using low-dose fentanyl with midazolam during thrombectomy for anterior-circulation acute ischemic stroke
10.3760/cma.j.issn.1672-7088.2018.16.005
- VernacularTitle:急性缺血性脑卒中支架取栓术中应用小剂量芬太尼联合咪达唑仑的护理
- Author:
Lifang CHEN
1
;
Wencai YANG
;
Jiancong CHEN
;
Peng ZHANG
;
Yumei LI
;
Jin'ai HE
Author Information
1. 暨南大学附属第一医院介入手术室
- Keywords:
Fentanyl;
Respiratory insufficiency;
Intraoperative care;
Acute ischemic stroke;
Thrombectomy;
Sedation
- From:
Chinese Journal of Practical Nursing
2018;34(16):1222-1226
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the nursing of sedation and analgesia using low-dose fentanyl with midazolam during intra-arterial treatment with mechanical thrombectomy by means of stent for patients with anterior-circulation acute ischemic stroke.Methods All of 61 patients who underwent intra-arterial treatment with anterior-circulation acute ischemic stroke were retrospectively collected.They were divided into two groups according to the different program of individual conscious sedation:the control group(30 cases)used midazolam for intravenous maintain sedation,experimental group(31 cases)added the low-dose fentanyl on the basis of the control group.The thrombectomy was performed by the same group of interventional radiologists,while the effect of sedative,vital signs,respiratory curve and SpO2(blood oxygen saturation),assessment of Ramsay's sedation score,restlessness and other sedation adverse reactions were respectively observed in both groups.Nursing intervention was performed aiming at different states of patients during operation.Results All 61 patients were implemented with good medical care with no intracranial hemorrhage or intraoperative death.In the control group,there were 4 patients with Ramsay 1 point of sedation,resulted motion artifacts in digital subtraction angiography images in 3 of them,1 patient with slight reduction of SpO2,and vomiting in 4 patients.1 patient with decreased mean arterial pressure.In the experimental group,there was no Ramsay 1 point of sedative patient.The SpO2 was decreased in 5 patients.Respiratory inhibition occurred in 3 patients and the mean arterial pressure decreased slightly in the other 3 patients.Conclusions Application of low-dose fentanyl and midazolam is safe and reliable in patients who underwent intra-arterial treatment with anterior-circulation acute ischemic stroke.While closely observation to the changes of breath frequency curve and SpO2 in operation are very essential to actively prevent the occurrence of respiratory depression.
