右美托咪定在纤维支气管镜检查中的应用  

Application of Dexmedetomidine in Fiberoptic Bronchoscopy

作　　者：王洪强 薛广燕[2] 

机构地区：[1]深圳宝安区西乡人民医院麻醉科,广东深圳518011 [2]南昌大学第二附属医院麻醉科,南昌330006

出　　处：《南昌大学学报（医学版）》2012年第4期58-60,65,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨在纤维支气管镜(纤支镜)检查中应用右美托咪定的有效性和安全性。方法将择期行纤支镜检查的180例患者按随机数字表法分为A、B、C 3组,每组60例。经表面麻醉后:A组静脉注射丙泊酚2mg.kg-1+4 mg.kg-1.h-1(维持);B组静脉注射右美托咪定1μg.kg-1(10 min注射完毕)+0.6μg.kg-1.h-1(维持);C组仅进行表面麻醉。监测3组各时点的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2),并记录3组镇静评分(RSS)、插管顺利与否及并发症发生情况。结果 A、B组患者MAP、HR在入声门和镜检中明显低于C组,差异有统计学意义(P<0.05);A、B组患者SpO2在镜检中明显高于C组(P<0.05);C组患者的RSS为0,B组患者的RSS较A组低,差异有统计学意义(P<0.05);C组患者插管顺利率较A、B组低,而插管困难率及插管失败率较A、B组明显升高,差异有统计学意义(P<0.05)。结论右美托咪定可安全、有效地应用于纤支镜的检查。Objective To evaluate the safety and efficiency of dexmedetomidine（Dex）in fiberoptic bronchoscopy.Methods A total of 180patients undergoing elective fiberoptic bronchoscopy were randomly divided into three groups,with 60patients in each group.After topical anesthesia,group A was intravenously injected with propofol for induction（2mg.kg-1）and maintenance（4mg.kg-1.h-1）.Group B was given Dex injection for induction（1μg.kg-1,within 10minutes）and maintenance（0.6μg.kg-1.h-1）.Group C only received topical anesthesia.Mean arterial pressure（MAP）,heart rate（HR）and blood oxygen saturation（SpO2）were monitored at different time points.Sedation scores（RSS）,intubation success rate and complications were determined in the three groups.Results Compared with group C,Dex significantly decreased the MAP and HR at the time points of tube entering the glottis and fiberoptic bronchoscopy but obviously increased RSS（P0.05）.Moreover,propofol or Dex significantly increased SpO2 and intubation success rate but obviously decreased difficult intubation rate and failed intubation rate,compared with group C（P0.05）.Conclusion The use of Dex is safe and effective in fiberoptic bronchoscopy.

关 键 词：右美托咪定 纤维支气管镜 镇静 有效性 安全性 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]