摘要
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10ml后检查，术中行鼻导管给氧；静脉麻醉组静脉注射普鲁泊福1．5mg／ks、芬太尼1μg／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（T1）、静脉注药后1min（T2）、纤支镜入声门即刻（T3）、纤支镜人声门后3min（T4）、检查结束后患者完全清醒时（L）的平均动脉压（MAP）、心率和脉搏血氧饱和度（SpO2）。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L、T4、T5MAP和心率较T。升高（P〈0．05）；静脉麻醉组T2MAP和心率较T1降低（P〈0．05），L心率较T1升高（P〈0．05）。与对照组比较，静脉麻醉组L、T4、T5MAP和心率降低（P〈0．05），T2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。
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 μg/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 （SpO2） were continuously monitored and recorded before induction of anesthesia （T1,baseline）, 1 min after intravenous injection （T2）, immediately and 3 min after intubation （T3, T4）, after FFB （T5）. 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 control group[ （ 1 ± 2）, （2 ± 3 ） scores and （7 ± 1 ）, （7 ± 3 ） scores ] （P 〈 0.05）. MAP and HR at T3,T4 and T5 were significantly increased compared with basehne values at T1 in control group （P 〈 0.05）. MAP and HR at T2 was lower than those at T1, HR at T3 was higher than that at TI in intravenous anesthesia group （P〈 0.05 ）. Compared with control group, MAP and HR at T3, T4 and T5 were lower, HR at T2 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 eff
出处
《中国医师进修杂志》
2010年第9期27-29,共3页
Chinese Journal of Postgraduates of Medicine
关键词
支气管镜
二异丙酚
芬太尼
麻醉
静脉
Bronchoscopes
Propofol
Fentanyl
Anesthesia,intravenous
