改良型spray-as-you-go注药法用于纤维支气管镜检查术气道表面麻醉的效果  

Efficay of modified spray-as-you-go technique for airway topical anesthesia in fiberoptic bronchoscopy

作　　者：顾伟[1] 顾小萍[1] 马正良[1] Gu Wei;Gu Xiaoping;Ma Zhengliang(Department of Anesthesiology,Drum Tower Hospital,Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,210008

出　　处：《中华麻醉学杂志》2020年第12期1491-1493,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价改良型spray-as-you-go注药法用于纤维支气管镜(FOB)检查术气道表面麻醉的效果。方法择期行FOB检查术患者120例,性别不限,年龄45~75岁,ASA分级Ⅰ或Ⅱ级。采用随机数字表法分为2组(n=60):改良型spray-as-you-go注药法组(S组)和常规对照组(C组)。S组全麻后采用改良型spray-as-you-go注药法于鼻腔、后联合、声带上方、声门下及主气管、隆突和两侧支气管近端喷洒2%利多卡因(各部位1.0~2.0 ml),C组于全麻前给予2%利多卡因20 ml超声雾化15 min。记录FOB检查期间呛咳评分、体动评分、低氧血症发生情况、丙泊酚用量、艾司洛尔和乌拉地尔使用率、FOB检查时间和患者苏醒时间;术后随访患者对FOB检查的满意度评分。结果与C组比较,S组FOB检查期间低氧血症发生率降低,体动评分及呛咳评分升高,苏醒时间及FOB检查时间缩短,丙泊酚用量减少,乌拉地尔、艾司洛尔使用率降低,患者满意度提高(P<0.05)。结论对于FOB检查术患者,改良型spray-as-you-go注药法表面麻醉效果确切,不良反应较少,效果优于传统超声雾化法。Objective To evaluate the efficay of modified spray-as-you-go technique for airway topical anesthesia in fiberoptic bronchoscopy(FOB).Methods A total of 120 male and female patients scheduled for elective FOB,aged 45-75 yr,of American Society of Anesthesiologists physical statusⅠorⅡ,were assigned to modified spray-as-you-go technique group(S group,n=60)and control group(C group,n=60)using a random number table method.In group S,modified spray-as-you-go technique was used to spray lignocaine on the nasal cavity,posterior oropharynx,glottis above vocal cords,subglottis,main trachea,carina and proximal ends of bilateral bronchus(1.0-2.0 ml for each site)after general anesthesia.Ultrasonic nebulization of lidocaine was performed for 15 min before general anesthesia in group C.The cough score,body movement score,occurrence of hypoxemia,consumption of propofol,and rate of esmolol and urapidil use during FOB examination,duration of FOB examination and emergence time were recorded.The patients were followed up for the score of patient′s satisfaction with FOB examination.Results Compared with group C,the incidence of hypoxemia was signifiantly decreased,body movement and bucking scores were increased,the emergence time and duration of FOB examination were shortened,the consumption of propofol was reduced,and the rate of urapidil and esmolol use was decreased,and patient′s satisfaction was increased in group S(P<0.05).Conclusion For the patients undergoing FOB examination,the modified spray-as-you-go technique provides reliable efficacy for airway topical anesthesia with fewer adverse reactions,and the efficacy is better than that of traditional ultrasonic nebulization.

关 键 词：麻醉 气管内 支气管镜检查 Spray-as-you-go 

分 类 号：R614[医药卫生—麻醉学]