布托啡诺超前镇痛复合右美托咪啶用于老年人超声支气管镜检查  

Application of butorphanol combined with dexmedetomidine in elderly patients received ultrasound fiberoptic bronchoscopy

作　　者：杨子文[1] 周桥灵[1] 洪美娟[2] 刘剑[3] 王汉兵[1] YANG Ziwen;ZHOU Qiaoling;HONG Meijuan;LIU Jian;WANG Hanbing(Department of Anesthesiology,First People′s Hospital of Foshan,Foshan 528000,China)

机构地区：[1]广东省佛山市第一人民医院麻醉科,广东佛山528000 [2]广东省佛山市第一人民医院超声诊疗中心,广东佛山528000 [3]广东省佛山市第一人民医院呼吸科,广东佛山528000

出　　处：《实用医学杂志》2018年第13期2221-2223,2227,共4页The Journal of Practical Medicine

基　　金：广东省临床重点专科建设资金资助(编号:粤卫文(2011)144);广东省科技厅资助项目(编号:2014A020212003);佛山市卫计局医学科研项目(编号:20170058)

摘　　要：目的评价布托啡诺超前镇痛复合右美托咪啶用于老年人超声支气管镜检查中的效果。方法拟行超声支气管镜检查患者80例,ASAⅠ~Ⅲ级,随机分为:对照组(C组)和布托啡诺组(B组),每组40例。C组患者术前10min静脉给予咪达唑仑0.05 mg/kg,芬太尼2μg/kg,并在2%利多卡因表麻下入镜。B组患者镜检前给予布托啡诺15μg/kg,右美托咪啶(Dex)0.6μg/kg,待Dex负荷量给予后靶控输注盐酸瑞芬太尼,达到靶浓度后开始入镜。分别记录给药前(T_0)、入镜前(T_1)、通过喉腔时(T_2)、通过隆突时(T_3)及镜检结束时(T_4)、镜检结束后5min(T_5)、10 min(T_6)及15 min(T7)患者平均动脉压(MBP)、心率(HR)、脉搏血氧饱和度(SpO_2)。并在T_0及T_5、T_6及T_7进行警觉/镇静(OAA/S)评分。结果与C组比较,B组患者MBP在T_2和T_3时降低,在T_2时HR降低,在T_3时SpO_2升高,镜检时间和利多卡因用量减少。镜检医师满意度评分和患者舒适度评分B组高于C组。两组患者OAA/S评分在T_5镜检结束时,B组低于C组,差异有统计学意义。结论布托啡诺超前镇痛复合右美托咪啶可以安全有效用于老年人超声支气管镜检查。Objective To evaluate the effects of butorphanol combined with dexmedetomidine in ultra-sound fiberoptic bronchoscopy for elderly patients.Methods Eighty elderly patients underwent fiberoptic bron-choscopy,were randomly divided into 2 groups:the control group(group C)and butorphanol group(B group),with 40 cases in each group.Patients in group C were given 0.05 mg/kg midazolam and 2μg/kg fentanyl with intra-venous injection and 2%lidocaine hydrochloride surface anesthesia for the ultrasound fiberoptic bronchoscopy.Pa-tients in B group received 15μg/kg butorphanol and 0.6μg/kg dexmedetomidine.The mean arterial pressure(MBP),heart rate(HR),pulse oxygen saturation(SpO2)of the patients were recorded before administration(T0),before the fiberoptic bronchoscopy(T1),through the laryngeal cavity(T2),through the carina(T3)and at the end of operation(T4),5 min(T5),10min(T6),15 min(T7)after the end of ultrasound fiberoptic bronchos-copy,respectively.The Observer--s assessment of Alertness/Sedation Scale(OAA/S)was recorded at T0 and T5,T6 and T7.Results There was no significant differences in age,sex,height,weight between the two groups.Com-pared with the group C,the MBP of the patients in group B decreased at T2 and T3,the HR decreased at T2 and SpO2,and increased at T3.The time of the ultrasound fiberoptic bronchoscopy for the patients in group B and the to-tal dosage of the lidocaine hydrochloride were less than those in group C,the sedation satisfaction score of the oper-ation physicians and the patients comfort score were better than those in group C.OAA/S score of the patients in group B was lower than that in group C.Conclusion Butorphanol combined with dexmedetomidine is a safe and effective sedation method for ultrasound fiberoptic bronchoscopy for elderly patients.

关 键 词：超声支气管镜 布托啡诺 右美托咪啶 老年患者 

分 类 号：R614[医药卫生—麻醉学]