芬太尼和丙泊酚复合静脉麻醉在无痛支气管镜检查中的临床应用  

Anesthesia with fentanyl and propofol in clinical application of painless electronic bronchoscopy

作　　者：刘爱群[1] 葛莲英[1] 刘立义[1] 陈桂言[1] 耿芳芳[1] 

机构地区：[1]广西医科大学附属肿瘤医院,广西南宁530021

出　　处：《临床肺科杂志》2010年第2期173-174,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨芬太尼和丙泊酚复合静脉麻醉在支气管镜检查中的安全性和有效性。方法A组40例患者在芬太尼和丙泊酚复合静脉麻醉后行支气管镜检查,B组40例患者常规局部麻醉在清醒状态下行支气管镜检查,两组同时监测记录各时点的收缩压、舒张压、心率、呼吸及指脉氧的变化,并观察其不适反应和调查痛苦记忆。结果A组40例均顺利完成检查,与术前比较,术中各期收缩压、舒张压、心率和呼吸略增加,但差异无显著性(P>0.05)。B组术中各期收缩压和舒张压明显上升,心率和呼吸增快,血氧饱和度下降,与术前比较,差异有显著性(P<0.05)。A组术后不能回忆当时情景,无不适感。B组>80%患者出现不同程度的反应性症状,有不同程度的痛苦记忆。结论芬太尼和丙泊酚复合静脉麻醉运用于支气管镜检查中具有安全,无痛苦,心肺抑制等副作用少等特点,患者易于接受,值得在临床支气管镜检查中推广。Objective To evaluate the safety and efficacy of intravenous anesthesia with fentanyl and propofol in clinical application of painless electronic bronchoscopy. Methods 80 cases of using bronchoscopy were randomly divided into two groups. Those in group A received intravenous anesthesia with fentanyl and propofol, whereas those in group B received only localanesthesia. The systolic blood pressure （SBP） , diastolic blood pressure （DBP） , heart rate （HR） , respiratory rate （ RR ） and pulse oxygen saturation （ SpO2 ） were measured in different periods. The reactive symptoms were observed during the operation and the memory of pain was inquired after every process. Results Those in group A,the operations were performed successfully,compared with before the operation, SBP, DBP, HR and RR were increased slightly, but the difference were not significaot （ P 〉 0. 05 ）. Those in group B, compared with before the operation, SBP, DBP, HR and RR increased while SpO2 decreased, and all comparisons of changes were significant （P 〈 0.05 ）. The patients in the group A reported no uncomfortable sensation,showing no memory of pain in the operation. While those in the group B,the different reactive symptoms were found in over 80% of the cases, and the memory of pain was significant. Conclusion The method of anesthesia with fentanyl and propofol is safe,with no pain and little adverse effect on the heart and lung. So it is worth generalizating in clinical application of painless electronic bronchoscopy.

关 键 词：支气管镜 芬太尼 丙泊酚 静脉麻醉 

分 类 号：R614[医药卫生—麻醉学] R768.1[医药卫生—外科学]