依托咪酯联合瑞芬太尼在无痛电子纤维支气管镜检查中的应用  

Application of etomidate combined with remifentanil in painless electronic fiberoptic bronchoscopy

作　　者：殷霞丽[1] 倪杰[2] YIN Xia-li;NI Jie(Department of Anesthesiology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210000,China;不详)

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,江苏南京210000 [2]南京大学医学院附属鼓楼医院急诊科,江苏南京210000

出　　处：《中国临床研究》2020年第11期1520-1522,1526,共4页Chinese Journal of Clinical Research

摘　　要：目的观察依托咪酯联合瑞芬太尼在无痛纤支镜检查中的应用效果。方法选取2016年1月至2018年6月呼吸内镜中心进行无痛纤支镜检查的75例患者为研究对象,随机分为A组、B组和C组。其中A组患者给予丙泊酚联合瑞芬太尼;B组患者给予依托咪酯联合瑞芬太尼;C组患者给予依托咪酯联合芬太尼。记录T0(麻醉前)、T1(诱导后)、T2(纤支镜通过声门)、T3(检查结束)、T4(离开手术室)各个时点三组患者的平均动脉压(MAP)、脉搏血氧饱和度(SpO2)情况,总麻醉药物使用量、术后苏醒时间和不良反应发生情况。结果MAP和SpO2在组间、时间及交互作用比较,差异有统计学意义(P<0.05,P<0.01),两两比较显示,MAP在T0、T1时刻三组比较差异无统计学意义(P>0.05),在T2、T3、T4时刻三组比较差异有统计学意义(P<0.01);SpO2在T0、T2、T3、T4时刻三组患者比较差异无统计学意义(P>0.05),T1时刻三组比较差异有统计学意义(P<0.05)。与B组和C组相比,A组药物使用量大,苏醒时间长,差异有统计学意义(P<0.05)。B组患者低血压发生率低于A组,差异有统计学意义(P<0.017)。结论在无痛纤支镜检查中,给予依托咪酯联合瑞芬太尼进行麻醉,能够安全有效的完成检查,同时达到快速苏醒的目的。Objective To observe the effect of etomidate combined with remifentanil in painless bronchoscopy.Methods 75 patients who underwent painless bronchoscopy at the Respiratory Endoscopy Center from January 2016 to June 2018 were selected as the research objects,and were randomly divided into group A,group B and group C.Patients in group A were given propofol combined with remifentanil;patients in group B were given etomidate combined with remifentanil;patients in group C were given etomidate combined with fentanyl.The mean arterial pressure(MAP) and Blood oxygen saturation(SpO2) of the three groups at each time point [T0(before anesthesia),T1(after induction),T2(bronchoscopy through the glottis),T3(end of examination),T4(leave the operating room)] were recorded.Total anesthetic usage,postoperative recovery time,and adverse reactions were compared.Results The differences of MAP and SpO2 between groups,time and interaction were statistically significant(P<0.05,P<0.01).Pairwise comparison showed that there was no statistical difference in MAP between the three groups at T0 and T1(P>0.05);There was a statistically significant difference between the three groups at T2,T3,and T4(P<0.01);There was no statistical difference between the three groups of SpO2 at T0,T2,T3 and T4(P>0.05);The comparison between the three groups at T1,the difference was statistically significant(P<0.05).Compared with group B and group C,group A used more drugs and took longer to wake up.The difference was statistically significant(P<0.05).The incidence of hypotension in group B was lower than that in group A,and the difference was statistically significant(P<0.017).Conclusion In painless bronchoscopy,the administration of etomidate combined with remifentanil for anesthesia can safely and effectively complete the examination and achieve the purpose of rapid recovery.

关 键 词：依托咪酯 瑞芬太尼 电子纤维支气管镜 麻醉 平均动脉压 血氧饱和度 

分 类 号：R614.2[医药卫生—麻醉学]