CAJ | 학술논문

目的评价普鲁泊福复合芬太尼静脉麻醉用于纤维支气管镜(纤支镜)检查的效果.方法择期行纤支镜检查患者40例,ASA分级Ⅰ～Ⅱ级,按随机数字表法分为对照组和普鲁泊福复合芬太尼静脉麻醉组(静脉麻醉组),每组各20例.两组术前均使用2%利多卡因行鼻腔和咽喉部表面麻醉.对照组静脉注射0.9%氯化钠10 ml后检查,术中行鼻导管给氧;静脉麻醉组静脉注射普鲁泊福1.5 mg/kg、芬太尼1 μg/kg麻醉诱导后开始检查,术中行内镜面罩给氧.记录两组患者麻醉前(T_1)、静脉注药后1 min(T_2)、纤支镜入声门即刻(T_3)、纤支镜人声门后3 min(T_4)、检查结束后患者完全清醒时(T_5)的平均动脉压(MAP)、心率和脉搏血氧饱和度(SpO_2).记录检查时间、苏醒时间、术后疼痛视觉模拟评分(VAS)、重复检查依从性评分和术中知晓情况.结果40例患者均顺利完成纤支镜检查.静脉麻醉组患者术后VAS和重复检查依从性评分[(1 ±2)、(2±3)分]均低于对照组[(7±1)、(7±3)分](P<0.05).对照组T_3、T_4、T_5MAP和心率较T_1升高(P<0.05);静脉麻醉组T_2MAP和心率较T_1降低(P<0.05),T_3心率较T_1升高(P<0.05).与对照组比较,静脉麻醉组T_3、T_4、T_5MAP和心率降低(P<0.05),T_2心率降低(P<0.05).静脉麻醉组患者均无术中知晓发生.结论普鲁泊福复合芬太尼静脉麻醉可安全有效地用于纤支镜检查.
목적 평개보로박복복합분태니정맥마취용우섬유지기관경(섬지경)검사적효과.방법 택기행섬지경검사환자40례,ASA분급Ⅰ～Ⅱ급,안수궤수자표법분위대조조화보로박복복합분태니정맥마취조(정맥마취조),매조각20례.량조술전균사용2%리다잡인행비강화인후부표면마취.대조조정맥주사0.9%록화납10 ml후검사,술중행비도관급양;정맥마취조정맥주사보로박복1.5 mg/kg、분태니1 μg/kg마취유도후개시검사,술중행내경면조급양.기록량조환자마취전(T_1)、정맥주약후1 min(T_2)、섬지경입성문즉각(T_3)、섬지경인성문후3 min(T_4)、검사결속후환자완전청성시(T_5)적평균동맥압(MAP)、심솔화맥박혈양포화도(SpO_2).기록검사시간、소성시간、술후동통시각모의평분(VAS)、중복검사의종성평분화술중지효정황.결과40례환자균순리완성섬지경검사.정맥마취조환자술후VAS화중복검사의종성평분[(1 ±2)、(2±3)분]균저우대조조[(7±1)、(7±3)분](P<0.05).대조조T_3、T_4、T_5MAP화심솔교T_1승고(P<0.05);정맥마취조T_2MAP화심솔교T_1강저(P<0.05),T_3심솔교T_1승고(P<0.05).여대조조비교,정맥마취조T_3、T_4、T_5MAP화심솔강저(P<0.05),T_2심솔강저(P<0.05).정맥마취조환자균무술중지효발생.결론 보로박복복합분태니정맥마취가안전유효지용우섬지경검사.
Objective To evaluate the effects of intravenous anesthesia with propofol and fentanyl on flexible fiberoptic bronchoscopy (FFB).Methods Forty ASA Ⅰ - Ⅱ patients undergoing elective FFB were randomly divided into two groups (20 cases in each group): control group and intravenous anesthesia group.All patients received airway local topical anesthesia with 2% lidocaine before the procedure.The patients in intravenous anesthesia group received propofol 1.5 mg/kg and fentanyl 1 μ g/kg intravenous injection for induction while in control group normal saline was given instead.Supplemental oxygen was administered by the endoscopy face mask.The mean arterial pressure (MAP),heart rate (HR)and pulse oxygen saturation (SpO_2) were continuously monitored and recorded before induction of anesthesia (T_1, baseline), 1 min after intravenous injection (T_2) ,immediately and 3 min after intubation (T_3,T_4),after FFB (T_5).The persistence time of the procedure was noted.When the patients responded to commands exactly, the recovery time was recorded.All patients were interviewed for the global tolerance to the procedure, the acceptance of another fiberoptic bronchoscopy and the degree of amnesia.Results All of the 40 patients finished FFB successfully.VAS postoperation and dependence scores were lower in intravenous anesthesia group than those in contrel group[(1±2),(2±3) scores and (7±1),(7±3) scores](P< 0.05).MAP and HR at T_3, T_4 and T_5 were significantly increased compared with baseline values at T_1 in control group (P <0.05).MAP and HR at T_2 was lower than those at T_1,HR at T_3 was higher than that at T_1 in intravenous anesthesia group (P < 0.05 ).Compared with control group, MAP and HR at T_3, T_4 and Ts were lower, HB at T_2 was lower in intravenous anesthesia group (P < 0.05).There was no awareness during the FFB in intravenous anesthesia group.Conclusion Intravenous anesthesia with propofol and fentanyl is safe and effective for FFB.