超声引导下喉上神经阻滞联合右美托咪定泵注在老年患者纤支镜检查术中的应用  

APPLICATION OF ULTRASOUND-GUIDED SUPERIOR LARYNGEAL NERVE BLOCK COMBINED WITH DEXMEDETOMIDINE PUMP INFUSION IN FIBEROPTIC BRONCHOSCOPY FOR ELDERLY PATIENTS

作　　者：林祺 蒋奕红[2] LIN Qi;JIANG Yihong(Graduate School of Guilin Medical University, Guilin 541000, China)

机构地区：[1]桂林医学院研究生院,广西桂林541000 [2]桂林医学院附属医院麻醉科

出　　处：《精准医学杂志》2020年第2期106-108,共3页Journal of Precision Medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研项目(Z20180424)。

摘　　要：目的研究超声引导下喉上神经阻滞联合右美托咪定泵注在老年患者纤维支气管镜(纤支镜)检查术中的应用价值。方法随机选取桂林医学院附属医院择期行无痛纤支镜检查术的老年患者120例,根据排除标准剔除后随机分为研究组和对照组,研究组行超声引导下喉上神经阻滞联合右美托咪定泵注,对照组则采用局麻药喷洒联合右美托咪定泵注。记录患者入手术室后(T0)、检查开始前(T1)、纤支镜进入声门即刻(T2)、纤支镜抵达隆突即刻(T3)、检查完成即刻(T4)、检查完成后10 min(T5)两组患者的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、清醒镇静(OAA/S)评分及呛咳≥2次的例数、躁动例数和术后1 d随访恶心呕吐及咽喉痛发生例数。结果研究组T2、T3时点MAP、HR及OAA/S评分与对照组相比明显降低(t=3.57~5.03,P<0.05);研究组术后咽喉痛发生率与对照组相比明显降低(χ^2=5.06,P<0.05)。结论老年患者行纤支镜检查采用超声引导喉上神经阻滞联合右美托咪定泵注麻醉效果更好,并可降低术后咽喉痛的发生率。Objective To investigate the value of ultrasound-guided superior laryngeal nerve block combined with dexmedetomidine pump infusion in fiberoptic bronchoscopy for elderly patients.Methods A total of 120 elderly patients who planned to undergo elective painless fiberoptic bronchoscopy in The Affiliated Hospital of Guilin Medical College were enrolled,and after screening based on exclusion criteria,they were randomly divided into experimental group and control group.The patients in the experimental group underwent ultrasound-guided superior laryngeal nerve block combined with dexmedetomidine pump infusion,while those in the control group were treated with local anesthetic spray combined with dexmedetomidine pump infusion.Mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation,Observer’s Assessment of Alertness/Sedation(OAA/S)score,and the numbers of patients with≥2 times of bucking and restlessness were recorded after admission into operating room(T0),before examination(T1),immediately after the fiberoptic bronchoscope entered the glottis(T2),immediately after the fiberoptic bronchoscope arrived at the carina(T3),immediately after the examination(T4),and at 10 min after examination(T5),and the number of patients with nausea/vomiting and sore throat was recorded on day 1 after surgery.Results At T2 and T3,the experimental group had significantly lower MAP,HR,and OAA/S score than the control group(t=3.57-5.03,P<0.05).The experimental group had a significantly lower incidence rate of postoperative sore throat than the control group(χ^2=5.06,P<0.05).Conclusion Ultrasound-guided superior laryngeal nerve block combined with dexmedetomidine pump infusion has a relatively good effect in elderly patients undergoing fiberoptic bronchoscopy and can reduce the incidence rate of postoperative sore throat.

关 键 词：支气管镜检查 右美托咪定 超声检查 介入性 神经传导阻滞 喉神经 老年人 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]