瑞芬太尼在中老年患者无痛支气管镜检查中的临床作用  

Clinical application of remifentanil in painless bronchoscopic examination of elderly patients

作　　者：廖兴志[1] 全耀晨 李国威 刘宇芳[1] 周脉涛[1] 

机构地区：[1]解放军第101医院麻醉科,无锡214044

出　　处：《重庆医学》2017年第26期3663-3665,共3页Chongqing medicine

摘　　要：目的探讨瑞芬太尼在中老年患者无痛支气管镜检查中的作用。方法将120例行无痛支气管镜检查的中老年患者随机分为4组(n=30),A组用丙泊酚麻醉,B、C、D组用瑞芬太尼复合丙泊酚麻醉(瑞芬太尼输注剂量:B组0.05μg·kg^(-1)·min^(-1),C组0.10μg·kg^(-1)·min^(-1),D组0.15μg·kg^(-1)·min^(-1))。观察各组患者在检查过程中的体动反应、血流动力学变化、丙泊酚用量、检查时间、苏醒时间、离室时间及不良反应。结果在检查过程中,A组的术中体动和呛咳明显高于其他3组(P<0.05);在血流动力学上,A组波动较大,B、C、D组相对较平稳,但D组低血压、心动过缓、一过性呼吸抑制发生率均较其他3组高(P<0.05);丙泊酚用量A组明显高于其他3组(P<0.05),B组高于C、D组(P<0.05);在苏醒时间和离室时间上B、C、D组明显优于A组(P<0.05),C、D组短于B组(P<0.05)。结论中老年患者在无痛支气管镜检查中可使用瑞芬太尼,且以0.10μg·kg^(-1)·min^(-1)的瑞芬太尼复合异丙酚麻醉效果较好。Objective To investigate the effects of remifentanil in painless bronchoscopic examination of elderly patients. Methods One hundred and twenty elderly patients undergoing painless bronehoscopic examination were randomly divided into 4 groups （n=30）,the group A was administered with propofol and the groups B, C and D were administered with propofol and remifentanil（remifentanil dose：0. 05μg · kg-1 · min-1 in the group B,0.10 μg · kg-1 · min-1 in the group C and 0. 15 μg · kg-1 · min-1 in the group D）. The body moving response,hemodynamic changes, propofol dose, examination time, wake-up time, departure time and adverse reactions in each group were observed during the examination process. Results During the examination process, the body moving response and bucking of the group A were significantly higher than those of the other three groups（P〈0.05） ;in he- modynamics,the group A fluctuated greatly, while the group B, C and D were relatively stable, but the incidence rate of hypoten- sion,bradycardia and transient respiratory depression of the group D were higher than those of the other three groups（P〈0.05）3 propofol dose of the group A was significantly higher than that of the other three groups （P〈0. 05）and the group B was higher than the group C and D（P〈0.05）. In wake-up time and departure time,the groups B,C,D were Significantly better than the group A（P〈0.05）, while the group C and D were better than the group B（P〈0.05）. Conclusion Remifentanil can be used in painless bronchoscopic examina- tion for elderly patients,and the effect is better by using propofol combined with remifentanil at a dose of 0.1 μg · kg-1 · min-1.

关 键 词：芬太尼 麻醉 瑞芬太尼 支气管镜检查 老年 

分 类 号：R614[医药卫生—麻醉学]