Chaoen Luo, Khan Asfandyar, Fan Hu, Shuangxi He, Qiaoling Liu, Lei Zhengwen
Luo Chaoen, Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Asfandyar Khan, Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):46-54. doi: 10.12669/pjms.40.1.8107.
To investigate the efficacy and safety of endotracheal intubation combined with deep analgesia and sedation in the prevention of preoperative dissection rupture in acute Standford type A aortic dissection.
This study evaluated the impact of preoperative endotracheal intubation combined with deep analgesia and sedation on acute Stanford Type-A aortic dissection. Conducted at the First Affiliated Hospital of the University of South China's cardiac intensive care unit from June 2018 to December 2021, 134 diagnosed patients participated. They were divided into experimental (n=42) and control (n=92) groups. Data collected included clinical details, biochemical markers, VAS and SAS scores, and preoperative dissection rupture occurrences. Criteria involved acute Stanford Type-A aortic dissection diagnosis and complete data. Exclusions encompassed rupture, vital sign instability after vasoactive drugs, or prolonged coma. Standardized methods were used for sample collection and analysis. The study's design, duration, and location ensured comprehensive evaluation of the intervention's effects on patients.
The experimental group showed significantly fewer deaths due to dissection rupture compared to the control group (P < 0.05). Initial VAS and SAS scores (T0) were similar between groups (P > 0.05), indicating good comparability. However, at T1, T2, and T3, analgesia and sedation were significantly better in the experimental group (P < 0.05). By T4, patient numbers were too low in both groups for a significant difference (P > 0.05).
Preoperative endotracheal intubation combined with deep analgesia and sedation in patients with acute Stanford Type-A aortic dissection can produce good analgesic and sedative effects, effectively reduce the incidence of preoperative dissection rupture, and create conditions for subsequent surgical treatment of patients.
探讨气管插管联合深度镇痛镇静在预防急性Stanford A型主动脉夹层术前夹层破裂中的有效性和安全性。
本研究评估术前气管插管联合深度镇痛镇静对急性Stanford A型主动脉夹层的影响。于2018年6月至2021年12月在南华大学附属第一医院心脏重症监护病房进行，134例确诊患者参与。他们被分为实验组（n = 42）和对照组（n = 92）。收集的数据包括临床细节、生化指标、视觉模拟评分（VAS）和状态焦虑量表（SAS）评分以及术前夹层破裂的发生情况。纳入标准包括急性Stanford A型主动脉夹层的诊断和完整数据。排除标准包括夹层破裂、使用血管活性药物后生命体征不稳定或长期昏迷。采用标准化方法进行样本采集和分析。研究的设计、持续时间和地点确保了对干预措施对患者影响的全面评估。
与对照组相比，实验组因夹层破裂导致的死亡明显减少（P < 0.05）。两组初始VAS和SAS评分（T0）相似（P > 0.05），表明具有良好的可比性。然而，在T1、T2和T3时，实验组的镇痛和镇静效果明显更好（P < 0.05）。到T4时，两组患者数量过少，无显著差异（P > 0.05）。
急性Stanford A型主动脉夹层患者术前气管插管联合深度镇痛镇静可产生良好的镇痛和镇静效果，有效降低术前夹层破裂的发生率，为患者后续手术治疗创造条件。
