环甲膜穿刺法气管表面麻醉与静脉无痛麻醉用于纤维支气管镜检查的效果比较  

A comparative study on the application effects of tracheal topical anesthesia by cricothyroid membrane puncture and by painless intravenous anesthesia in analgesia fiberoptic bronchoscopy

作　　者：崔晓艳 刘庆华 孙梅婷 杨杰 杜其超 CUI Xiaoyan;LIU Qinghua;SUN Meiting(The Sixth People’s Hospital of Hengshui City,Hebei, Hengshui 053200,China)

机构地区：[1]河北省衡水市第六人民医院,053200

出　　处：《河北医药》2020年第9期1362-1364,1368,共4页Hebei Medical Journal

摘　　要：目的观察环甲膜穿刺气管表面麻醉复合静脉麻醉在无痛纤维支气管镜检查中的应用效果。方法选取需要做维纤支气管镜检查的成人患者120例,随机分为2组。试验组患者60例,行环甲膜穿刺阻滞后,给予静脉麻醉药;对照组患者60例,直接给予静脉麻醉药。静脉麻醉药:地佐辛0.04 mg/kg,丙泊酚1.0~1.5 mg/kg缓慢静脉推注(40~60 s推注完毕)。术中靶控泵入丙泊酚,维持其血浆浓度至1.5μg/ml。观察2组患者操作前、操作中及术后收缩压(SP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SPO2)的变化情况,记录呛咳、体动等不良反应,采集患者和内镜医师的满意度。结果试验组患者SP、HR、SPO2较平稳,呛咳发生率均低(P<0.05),医师满意度高(P<0.05)。结论环甲膜穿刺气管内表面麻醉用于无痛维纤支气管镜检查,可以有效地减少心血管反应和气道反应,患者和内镜医师的满意度高,是一种值得推广的无痛麻醉技术。Objective To investigate the application effects of tracheal topical anesthesia by cricothyroid membrane puncture and by painless intravenous anesthesia in analgesia fiberoptic bronchoscopy.Methods A total of 120 adult patients who had to be examined by fiberoptic bronchoscopy were randomly divided into experimental group and control group,with 60 cases in each group.The patients in experimental group were given intravenous anesthetics after intratracheal topical anesthesia by cricothyroid membrane puncture,however,the patients in control group were given intravenous anesthetics only.The intravenous anesthetics were:0.04mg/kg of dizosin,1.0~1.5mg/kg of propofol,and the plasma concentration of propofol was maintained at 1.5μg/ml by target controlled infusion of propofol intraoperatively.The changes of BP,HR and SpO2 before operation,during operation and after operation were observed,moreover,the adverse reactions including bucking and physical activity,and the satisfaction degree of patients and endoscopists were observed and compared between the two groups.Results The levels of BP,HR and SpO2 were stable in experimental group,and the incidence rate of bucking in experimental group was significantly lower than that in control group(P<0.05),and the satisfaction degree of doctors in experimental group was significantly higher than that in control group(P<0.05).Conclusion The application of tracheal topical anesthesia by cricothyroid membrane puncture in analgesia fiberoptic bronchoscopy can effectively reduce the cardiovascular and airway reactions,and the degree of satisfaction of patients and the endoscopists is higher,thus,it is worthy of popularizing in clinical practice.

关 键 词：气管内表面麻醉 环甲膜穿刺 静脉全麻 纤维支气管镜检查 

分 类 号：R614[医药卫生—麻醉学]