摘要
目的观察低剂量依托咪酯辅助右美托咪定和瑞芬太尼在电子支气管镜检查中的临床效果,以及达到医患满意所需的安全剂量范围。方法72例拟行电子支气管镜检查患者,随机分为观察A组、观察B组、对照组,每组24例。入镜前1 min观察A组静脉推注依托咪酯0.05 mg/kg,观察B组静脉推注依托咪酯0.1 mg/kg,对照组给予等容量生理盐水。记录比较三组患者麻醉前(T_(0))、入镜前(T_(1))、声门喷洒利多卡因时(T_(2))、过气管隆突喷洒利多卡因时(T_(3))、镜检结束时(T_(4))、镜检结束10 min(T_(5))时的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)和脉搏血氧饱和度(SpO_(2))水平、镇静警觉(OAA/S)评分、不良反应[呼吸暂停、低氧血症(SpO_(2)≤80%)、高血压、心动过速]发生情况以及术后30 min的记忆情况。结果与T_(0)相比,观察A组和观察B组患者在T_(1)、T_(2)、T_(3)、T_(4)、T_(5)的MAP均有明显降低,而对照组在T_(2)和T_(3)均明显升高,且对照组在T_(1)、T_(2)、T_(3)时的MAP均高于观察A组和观察B组;三组患者的HR均在T_(2)和T_(3)明显升高,且对照组升幅最大;观察A组和对照组在T_(1)、T_(2)、T_(4)、T_(5)的RR水平均低于T_(0),观察B组T_(1)、T_(2)、T_(3)、T_(4)、T_(5)的RR水平均低于T_(0);三组患者在T_(2)、T_(3)、T_(4)时的SpO_(2)水平均低于本组T_(0)时,且观察B组降幅最大,观察B组在T_(2)、T_(3)、T_(4)时的SpO_(2)均低于对照组,观察A组T_(4)时的SpO_(2)低于对照组,差异均具有统计学意义(P<0.05)。观察A组T_(0)、T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时的OAA/S评分分别为(5.0±0.0)、(2.1±0.4)、(2.5±0.5)、(2.5±0.5)、(2.0±0.4)、(4.0±0.2)分;观察B组T_(0)、T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时的OAA/S评分分别为(5.0±0.0)、(1.2±0.4)、(1.7±0.6)、(1.6±0.6)、(1.8±0.4)、(3.8±0.4)分;对照组T_(0)、T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时的OAA/S评分分别为(5.0±0.0)、(3.1±0.6)、(3.6±0.5)、(3.5±0.5)、(
Objective To observe the clinical effect and safe dose of low-dose etomidate assisted dexmedetomidine and remifentanil in electronic bronchoscopy.Methods A total of 72 patients undergoing electronic bronchoscopy were randomly divided into observation group A,observation group B and control group,with 24 cases in each group.1 min before bronchoscopy,observation group A received intravenous injection of etomidate 0.05 mg/kg,observation group B received intravenous injection of etomidate 0.1 mg/kg,and control group received equal volume of normal saline.The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR)and blood oxygen saturation(SpO_(2))levels,observer’s assessment of alertness/sedation(OAA/S)score before anesthesia(T_(0)),before bronchoscopy(T_(1)),during glottal injection of lidocaine(T_(2)),during injection of lidocaine into the carina of pertrachea(T_(3)),at the end of bronchoscopy(T_(4)),and 10 min after the bronchoscopy(T_(5)),occurrence of adverse reactions[apnea,hypoxemia(SpO_(2)≤80%),hypertension,tachycardia],and memory at 30 min after operation of the three groups were recorded and compared.Results Compared with T_(0),the MAP of observation group A and observation group B at T_(1),T_(2),T_(3),T_(4),T_(5) were significantly reduced;however,the control group was significantly increased at T_(2) and T_(3),and the MAP of the control group at T_(1),T_(2),and T_(3) were higher than those of observation group A and observation group B;the HR of the three groups all increased significantly at T_(2) and T_(3),and the control group increased the most.The RR levels of observation group A and the control group at T_(1),T_(2),T_(4),T_(5) were lower than T_(0),and the RR levels of observation group B at T_(1),T_(2),T_(3),T_(4),T_(5) were lower than those of this group at T_(0).The SpO_(2) levels of the three groups at T_(2),T_(3),and T_(4) were lower than those of this group at T_(0),and the observation group B had the largest decrease.The SpO_(2) of observation group B at T_(2),T_(3),T_(4) was low
作者
李露君
刘洪珍
李世杰
张瑜
赖晓红
章绵华
高润兴
谭燕
LI Lu-jun;LIU Hong-zhen;LI Shi-jie(Ambulatory Surgery Center,Foshan First People’s Hospital,Foshan 528000,China)
出处
《中国现代药物应用》
2021年第11期121-124,共4页
Chinese Journal of Modern Drug Application
基金
佛山市卫生健康局医学科研课题(项目编号:20200218)。
