七氟烷复合丙泊酚-芬太尼麻醉在无痛纤支镜检查中的应用  

Application of sevoflurane combined with propofol-fentanyl anesthesia in fiberoptic bronchoscopy

作　　者：何伟[1] 原庆会[1] 赖庆莉[1] 唐晓凤[1] 杨天风[1] 李卫[1] 

机构地区：[1]绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《四川医学》2011年第10期1549-1551,共3页Sichuan Medical Journal

摘　　要：目的观察七氟烷吸入联合丙泊酚-芬太尼复合静脉麻醉用于无痛苦纤支镜检的麻醉效果。方法 40例患者,随机分为两组,七氟烷复合丙泊酚-芬太尼全身麻醉组(GA组,n=21)和表面麻醉组(SA组,n=19)。分别记录麻醉前(T0)、麻醉后纤支镜进入前(T1)、进镜至咽部(T2)、声门部(T3)、气管内(T4)及第15 min(T5)时的血压(BP)、心率(HR)和脉搏血氧饱和度(SpO2),观察镜检期间有无呛咳、气道痉挛或体动;记录停药至拔管的时间,麻醉满意度(由内镜医师评价)及麻醉再接受度(由患者评价)。结果 GA组患者术中血流动力学稳定,SA组HR、MAP在各时点均升高,与T0比较差异有统计学意义(P<0.05),组间比较差异亦有统计学意义(P<0.05);GA组患者镜检期间1例轻微呛咳,S组患者大部分均有呛咳、体动,其中有1例因不能耐受而中断检查;GA组患者均能在术毕5～10min苏醒,麻醉满意度及患者再接受度均显著高于SA组(P<0.01)。结论七氟烷复合丙泊酚-芬太尼全麻用于无痛苦纤支镜检查,能保证稳定的血流动力学状态,苏醒快速,效果满意。Objective To assess the feasibility and safety of sevoflurane combined with propofol-fentanyl in painless fiberoptic bronchoscopy anesthesia.Methods Forty ASAⅠ～Ⅱ patients scheduled for fiberoptic bronchoscopy were randomly divided into 2 groups： general anesthesia with sevoflurane combined with propofol-fentanyl group（GA） and surface anesthesia group（SA）.In GA group,general anesthesia was induced with 2～5% sevoflurane and fentanyl 1.0μg/kg,and then mentained with propofol.Fiberoptic bronchoscopy in group SA was carried out after surface anesthesia.All patients＇ BP,HR,SpO2 and the time interval were recorded in fiberoptic bronchoscopy.The satisfaction of patients doctors was also evaluated.Results Compared with the group SA,the satisfaction of the GA group was significantly higher and circulation fluctuation was relatively minimal.Conclusion General anesthesia with sevoflurane combined with propofol-fentanyl provide satisfactory anesthesia for painless fiberoptic bronchoscopy.

关 键 词：七氟烷 丙泊酚 芬太尼 全身麻醉 表面麻醉 纤维支气管镜检查 血流动力学 

分 类 号：R614[医药卫生—麻醉学]