比较靶控输注瑞芬太尼复合丙泊酚或依托咪酯用于电子支气管镜介入治疗的呼吸抑制情况和麻醉效果  

Comparison of Target-controlled Infusion of Remifentanil with Propofol or Etomidate for Respiratory Depression and Anesthetic Effects in Electronic Bronchoscopy

作　　者：王洋[1] 杨海涛[1] WANG Yang;YANG Hai-tao(Department of Anesthesia,the Second Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province,116027 China)

机构地区：[1]大连医科大学附属第二医院麻醉科,辽宁大连116027

出　　处：《系统医学》2018年第3期10-12,共3页Systems Medicine

摘　　要：目的比较靶控输注瑞芬太尼复合丙泊酚或依托咪酯用于电子支气管镜介入治疗的呼吸抑制情况和麻醉效果。方法该文选择医院麻醉科2016年7月—2017年7月ASAⅡ或Ⅲ级行纤维支气管镜介入治疗的94例患者为研究对象,随机分为两组,每组47例,依托咪酯组实施靶控输注瑞芬太尼复合依托咪酯治疗,实现组实施靶控输注瑞芬太尼复合异丙酚治疗,对比两组患者麻醉以及入镜十五分钟后的苏醒时间和手术时间、动脉血氧分压和二氧化碳分压以及不良反应发生率。结果依托咪酯组苏醒时间为(6.88±1.73)min,丙泊酚组苏醒时间为(5.23±1.62)min,丙泊酚组苏醒时间明显比丙泊酚组长,两组差异有统计学意义(t=6.516,P<0.05)。相比于麻醉之前的(45.38±2.85)mmHg,丙泊酚组患者在入镜之后的15 min左右,PaCO_2显著升高为(70.23±4.52)mmHg,差异有统计学意义(t=4.186,P<0.01)。另外,相比于麻醉之前的(96.25±5.21)mmHg,丙泊酚组患者在入镜之后的15 min左右,PaO_2显著降低为(72.54±4.88)mmHg,差异有统计学意义(t=8.675,P<0.01)。还有,依托咪酯组患者的注射痛发生例数和低血压发生例数明显比丙泊酚组少,但恶心呕吐发生例数和肌阵挛发生例数明显比丙泊酚组多(χ~2=0.4332,P=0.510 4)。结论相比于依托咪酯,在电子支气管镜介入治疗当中实施靶控输注瑞芬太尼复合丙泊酚治疗,有更为显著的呼吸抑制作用,而且可使苏醒时间缩短,减少肌阵挛发生例数以及恶心呕吐发生例数,保障麻醉效果。Objective This paper tries to compare target-controlled infusion of remifentanil with propofol or etomidate for respiratory depression and anesthetic effects in electronic bronchoscopic interventional therapy. Methods 94 patients with ASA Ⅱ or Ⅲ-level bronchofibroscopic interventional treatment from July 2016 to July 2017 in the hospital were selected. The patients were randomly divided into two groups（with 47 in each group）. Remifentanil combined with etomidate treatment group, the implementation of target-controlled infusion of remifentanil combined with propofol treatment, compared two groups of patients anesthesia and into the lens after 15 minutes of recovery time and operation time, arterial oxygen partial pressure and partial pressure of carbon dioxide and the incidence of adverse reactions.Results The wake time of etomidate group was（6.88 ± 1.73） min, that of propofol group was（5.23 ± 1.62） min, that of propofol group was longer than that of propofol group（t=6.516,P〈0.05）. Compared with（45.38 ± 2.85）mmHg prior to anesthesia, PaCO2 increased significantly to（70.23 ± 4.52） mmHg in propofol group at 15 minutes after entry, with significant difference（t=4.186, P〈0.01）. In addition, after 15 min PaO2 was significantly reduced to（72.54 ± 4.88） mmHg in the propofol group compared with（96.25 ± 5.21） mmHg prior to anesthesia, the difference was statistically significally（t=8.675, P〈0.01）. In addition, the number of cases of injection pain and the incidence of hypotension in the etomidate group were significantly less than those in the propofol group, but the number of nausea and vomiting cases and the number of myoclonus cases were significantly higher than those in the propofol group（cm^2=0.433 2,P=0.510 4）. Conclusion In contrast to etomidate, target-controlled infusion of remifentanil combined with propofol for the treatment of bronchoscopic interventional therapy resulted in more pronounced respiratory depression and shortened wakefulness and decrease

关 键 词：靶控输注瑞芬太尼 丙泊酚 依托咪酯 电子支气管镜介入治疗 呼吸抑制情况 

分 类 号：R971.2[医药卫生—药品]