摘要
目的探讨脑电双频指数(BIS)监测下右美托咪定联合丙泊酚和舒芬太尼在无痛支气管镜检查中的临床效果。方法选取2019年4月-2019年7月接受气管镜检查的患者70例,随机分为观察组(右美托咪定组35例)和对照组(丙泊酚组35例)。观察两组患者的术中血流动力学、镇静评分、BIS值、药物使用量、手术时间、术后不良反应、患者及医师满意度,并进行对比分析。结果观察组术中血流动力学较对照组平稳,T5时点平均动脉压(MAP)、T4~T8脉搏血氧饱和度(SpO2)较对照组高,而术中心率(HR)、BIS值较对照组低;两组改良警觉/镇静评分(MOAA/S)比较,在T2~T7时间点组间差异无统计学意义(P>0.05);观察组麻醉时间、苏醒时间和出室时间较对照组长,两组比较,差异均有统计学意义(P<0.05);观察组丙泊酚使用量少于对照组[(157.71±55.38)和(213.14±58.44)mg,P<0.05];在不良反应方面,观察组出现呛咳6例(17.14%)和低氧血症4例(11.43%),均明显低于对照组,两组比较,差异有统计学意义(P<0.05);观察组患者和医师满意度评价均高于对照组。结论BIS监测下使用右美托咪定联合药物的方法可安全用于支气管镜麻醉,能够在维持相似镇静深度的同时,提供稳定的血流动力学,减少不良反应的发生,提高患者及手术医师的满意度。
Objective To explore the clinical effect of Dexmedetomidine combined with Propofol and Sufentanil in painless bronchoscopy with bispectral index monitoring.Methods There were 70 patients included in the study and randomly divided into two groups from April 2019 to July 2019:the observation group(35 cases of Dexmedetomidine group)and the control group(35 cases of Propofol group).The intraoperative hemodynamics,sedation score,BIS value,drug consumption,operation time,postoperative adverse reactions,satisfaction of patient and physician were observed and compared between the two groups.Results Compared with the control group,in the observation group,the intraoperative hemodynamics were more stable,the mean arterial blood pressure at T5 and the oxygen saturation of blood at T4~T8 were higher,heart rate and BIS value were lower during the operation.There was no significant difference in the MOAA/S sedation score between the two groups at T2~T7(P>0.05).In terms of operation time,the anesthesia time,recovery time and out of the room time of the observation group were longer,and the difference was statistically significant(P<0.05).The use of Propofol in the observation group was lower than that in the control group[(157.71±55.38)vs(213.14±58.44)mg,P<0.05].In terms of postoperative adverse reactions,6 cases of cough(17.14%)and 4 cases of hypoxemia(11.43%)in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).In the evaluation of patients’and physicians’satisfaction,the score of the observation group was higher than that of the control group.Conclusion The method of Dexmedetomidine combined with drugs under the monitoring of bispectral index could be safely used in the anesthesia of flexible bronchoscopy.It could maintain the similar depth of sedation,provide stable hemodynamics,reduce the occurrence of adverse reactions,and improve the satisfaction of patients and physicians.
作者
韩锋
田欣欣
王莹
宋俊杰
陈慧娜
杨立峰
Feng Han;Xin-xin Tian;Ying Wang;Jun-jie Song;Hui-na Chen;Li-feng Yang(Department of Anesthesiology,the First Affiliated Hospital of Henan University,Kaifeng,Henan 475000,China;Department of Gastroenterology,Huaihe Hospital of Henan University,Kaifeng,Henan 475000,China)
出处
《中国内镜杂志》
2020年第7期38-46,共9页
China Journal of Endoscopy
基金
开封市科技创新团队(No :10028)。
