瑞马唑仑联合喉上神经阻滞对电子支气管镜检查患者术后早期恢复质量的影响  

Effect of combination between Rimimazolam and ultrasound-guided superior laryngeal nerve block on quality of early postoperative recovery in patients undergoing bronchoscopy

作　　者：何香芗 何文胜 张军[2] 王凯[2] HE Xiangxiang;HE Wensheng;ZHANG Jun;WANG Kai(Anesthesiology Department of Hefei Hospital Affiliated to Anhui Medical University(Hefei Second People's Hospital),Anhui Hefei 2300032;Department of Anesthesiology,Fifth Clinical Medical College,Anhui Medical University,Anhui Hefei 2300032)

机构地区：[1]安徽医科大学附属合肥医院(合肥市第二人民医院)麻醉科,安徽合肥2300032 [2]安徽医科大学第五临床医学院麻醉科,安徽合肥2300032

出　　处：《中文科技期刊数据库(全文版)医药卫生》2023年第6期75-82,共8页

摘　　要：目的 探讨单纯瑞马唑仑及瑞马唑仑联合超声引导下喉上神经阻滞对电子支气管镜手术患者围术期生命体征的稳定性及术后康复的影响。方法 90例患者在排除脱落后,根据随机以及双盲原则,通过密封信封的方法和随机数字表法分成3组各30例:S组患者麻醉诱导时静脉缓慢注射瑞马唑仑0.3mg/kg后用迈瑞超声仪实行超声引导联合下喉上神经阻滞,在喉上神经根包裹注射1%利多卡因6ml;H组患者麻醉诱导时静脉缓慢推注瑞马唑仑0.3mg/kg.C组患者麻醉诱导时静脉缓慢推注丙泊酚3mg/kg,三组患者术中都使用静脉微量泵通过静脉三通接头泵注异丙酚6-8mg/kg/h,通过维持术中BIS值在50~60左右来判断麻醉深度。结果 三组患者丙泊酚围术期使用总量,差异无统计学意义(P>0.05);S组围手术期低血压及高血压的发生率显著低于H组及C组(P<0.05);三组组间插管反应及恶心呕吐的发生率比较,差异无统计学意义(P>0.05),但S组发拔管反应显著低于其它两组(F组及C组)(P<0.05)。结论 瑞马唑仑联合超声引导下喉上神经阻滞用于电子支气管镜检查时患者围术期血流动力学更加稳定、围术期阿片类药物使用剂量降低、术后早期恢复质量相较于使用单纯静脉麻醉药有所改善。围术期不良事件发生率更低。Objective To investigate the effects of rimazolam alone and rimazolam combined with ultrasound-guided supraglottic nerve block on the stability of perioperative vital signs and early postoperative recovery of patients undergoing electronic bronchoscopy,and to provide reference for clinical treatment.Methods After 90 patients were excluded,they were divided into 3 groups of 30 patients each by sealed envelope method and random number table method according to the principle of randomization as well as double-blindness:Group S patients were inducted into anesthesia with intravenous slow injection of rimazolam 0.3mg/kg and then ultrasound-guided combined supraglottic nerve block was performed with a Myriad ultrasound instrument,and 1%lidocaine 6ml was injected into the supraglottic nerve root package;Group H patients were inducted into anesthesia with intravenous slow injection of rimazolam 0.3mg/kg.In Group H,rimazolam 0.3mg/kg were administered slowly intravenously;in Group C,propofol 3mg/kg were administered slowly intravenously during induction of anaesthesia.Primary indicators:Quality of Recovery Scale(QoR-40)scores at the ward bedside 1 day before(T0)and 1 day after(T5);total perioperative doses of remifentanil and isoproterenol in the three groups;and the incidence of perioperative apnoea,postoperative nausea and vomiting,intraoperative intubation and extubation reactions.Secondary indicators:changes in mean arterial pressure(MAP),pulse oximetry(SpO2),heart rate(HR)and electroencephalographic bifrequency index(BIS)values before induction of anaesthesia(T1),immediately after the mask was placed and adjusted to the appropriate position(T2),immediately after the flexible fibrinoscope core entered the voice box(T3)and immediately after the end of tracheoscopy and exit from the voice box(T4)in the three groups.Results:The total perioperative use of propofol in the three groups was not statistically significant(P>0.05);the incidence of perioperative hypotension and hypertension in group S was significantly lower tha

关 键 词：瑞马唑仑 超声引导下喉上神经阻滞 QoR-40 量表 电子支气管镜检查 

分 类 号：R4[医药卫生—临床医学]