CAJ | 학술논문

目的观察瑞芬太尼靶控输注( TCI )复合依托咪酯静脉麻醉在支气管镜检查中的麻醉效果及对呼吸、循环的影响。方法选取24例采用瑞芬太尼+依托咪酯复合静脉麻醉进行纤支镜检患者作为治疗组,另选取36例采用利多卡因表面麻醉检查患者作为对照组。治疗组患者予以靶控输注瑞芬太尼并静脉滴注依托咪酯脂肪乳注射液；对照组患者以2%利多卡因进行表面麻醉。连续监测所有患者检查前、检查中、完全清醒时各组的经皮氧饱和度( SpO2)、血压、心率及呼吸变化,同时记录纤支镜检查时间,检查中体动、呛咳及检查后患者的满意程度等。结果治疗组患者检查中无明显体动、剧烈呛咳等不适,无内镜检查过程及任何痛苦记忆。对照组术中患者均有不同程度体动、剧烈呛咳等不适,术后多数患者有痛苦记忆,与治疗组患者比较,差异有统计学意义(P<0.01)。治疗组患者检查中及检查后血压、呼吸频率、心率及SpO2与检查前比较均降低,差异有统计学意义(P<0.01)；对照组患者检查过程中的血压、呼吸频率及心率明显增加,SpO2降低,与检查前比较,差异有统计学意义(P<0.01),而其检查中SpO2降低与治疗组比较差异无统计学意义(P>0.05)。结论靶控输注瑞芬太尼复合依托咪酯静脉缓注可为纤支镜检查提供安全可靠快捷的麻醉。
목적관찰서분태니파공수주( TCI )복합의탁미지정맥마취재지기관경검사중적마취효과급대호흡、순배적영향。방법선취24례채용서분태니+의탁미지복합정맥마취진행섬지경검환자작위치료조,령선취36례채용리다잡인표면마취검사환자작위대조조。치료조환자여이파공수주서분태니병정맥적주의탁미지지방유주사액；대조조환자이2%리다잡인진행표면마취。련속감측소유환자검사전、검사중、완전청성시각조적경피양포화도( SpO2)、혈압、심솔급호흡변화,동시기록섬지경검사시간,검사중체동、창해급검사후환자적만의정도등。결과치료조환자검사중무명현체동、극렬창해등불괄,무내경검사과정급임하통고기억。대조조술중환자균유불동정도체동、극렬창해등불괄,술후다수환자유통고기억,여치료조환자비교,차이유통계학의의(P<0.01)。치료조환자검사중급검사후혈압、호흡빈솔、심솔급SpO2여검사전비교균강저,차이유통계학의의(P<0.01)；대조조환자검사과정중적혈압、호흡빈솔급심솔명현증가,SpO2강저,여검사전비교,차이유통계학의의(P<0.01),이기검사중SpO2강저여치료조비교차이무통계학의의(P>0.05)。결론파공수주서분태니복합의탁미지정맥완주가위섬지경검사제공안전가고쾌첩적마취。
Objective To discuss the safety of using etomidate combined with remifentanil by target controlled infusion ( TCI) for painless bronchofibroscopy. Methods Sixty patients were divided into two groups: painless bronchoscopy group (treatment group, 24 patients) and the routine bronchoscopy group (control group, 36 patients). Treatment group received TCI of remifentanil and intravenous injection of etomidate fat emulsion. Control group was subjected to surface anesthesia with 2%lidocaine. SpO2 , blood pressure, heart rate and breath changes during examination and complete awakening were continuously monitored. Bronchofiberscopy time, body movement during examination, bucking and satisfaction degree after examination were also recorded. Results Treatment group patients felt senseless and painless during bronchoscopy, without memory of bronchoscopy and pain. Patients in control group had discomfort, body movement and acute bucking, and most of them had painful memory. There were significant differences between the two groups (P<0. 01). In treatment group, after examination, blood pressure, respiratory frequency, heart rate and SpO2 were significantly decreased (P<0. 01). During examination, the blood pressure, respiratory frequency and heart rate were increased, and SpO2 decreased in control group compared to the baseline (P<0. 01). There was no significant difference in SpO2 between treatment group and control group during examination (P>0. 05). Conclusion TCI etomidate combined with remifentanil during bronchoscopy achieved satisfying anesthetic effect.