对比低、中、高剂量的瑞芬太尼方案在全麻下经喉罩纤支镜手术中的应用效果和不良反应情况  

Objective to compare the application effect and adverse reactions of low,medium and high doses of remifentanil in laryngeal mask airway fiberoptic bronchoscopy surgery under general anesthesia

作　　者：李昕蓬 LI Xinpeng(Department of Anesthesiology,Chaoyang Second Hospital,Chaoyang,Liaoning,122000,China)

机构地区：[1]辽宁省朝阳市第二医院麻醉科,辽宁朝阳122000

出　　处：《当代医学》2021年第32期61-63,共3页Contemporary Medicine

摘　　要：目的探究低、中、高剂量的瑞芬太尼方案在全麻下经喉罩纤支镜手术中的应用效果和不良反应情况。方法回顾性分析2019年3月至2020年3月于本院进行经喉罩纤支镜手术的120例患者的临床资料,患者均给予全麻,并在瑞芬太尼、丙泊酚的诱导下,插入喉罩与连接呼吸机,按瑞芬太尼麻药剂量的不同分为低剂量组、中剂量组和高剂量组,剂量分别为0.2μg/(kg•min)、0.3μg/(kg•min)、0.4μg/(kg•min),每组40例。比较3组手术操作时间、麻醉时间、苏醒时间,以及入室时、诱导前5 min内、喉罩置入前1 min、喉罩置入后即刻、纤支镜通过声门即刻、纤支镜通过隆突即刻、纤支镜撤出即刻、苏醒时的平均动脉压、心率、脑电双频指数,比较3组不良反应发生情况。结果3组手术操作时间、麻醉时间、苏醒时间比较差异无统计学意义。中剂量组、高剂量组在纤支镜通过声门即刻、纤支镜通过隆突即刻的平均动脉压、心率、脑电双频指数均低于低剂量组(P<0.05);中剂量组、高剂量组在纤支镜撤出即刻的脑电双频指数低于低剂量组(P<0.05)。低剂量组不良反应发生率为15.00%,中剂量组与高剂量组均未发生任何不良反应,3组不良反应发生率比较差异具有统计学意义(P<0.05)。结论低剂量的瑞芬太尼容易诱发高血压、呛咳等不良反应,而0.3μg/(kg•min)、0.4μg/(kg•min)的使用剂量更适合全麻下经喉罩纤支镜手术的需求。Objective To explore the application effect and adverse reactions of low,medium and high dose remifentanil in laryngeal mask airway surgery under general anesthesia.Methods The clinical data of 120 patients who underwent laryngeal mask airway fiberoptic bronchoscopy surgery in our hospital from March 2019 to March 2020 were retrospectively analyzed.All patients were given general anesthesia.Under the induction of remifentanil and propofol,the laryngeal mask was inserted and the ventilator was connected.According to the different doses of remifentanil,they were divided into low dose group,middle dose group and high dose group,the doses were 0.2μg/(kg•min),0.3μg/(kg•min),respectively 4μg/(kg•min),with 40 cases in each group.The operation time,anesthesia time,and recovery time of the three groups were compared;at the time of entry,within 5 minutes before induction,1 minute before laryngeal mask insertion,immediately after laryngeal mask insertion,immediately after the bronchoscope passes through the glottis,immediately after the bronchoscope passes through the carina,immediately after the bronchoscope is withdrawn,and wakes up at time,compare the average arterial pressure,heart rate,EEG bispectral index of the 3 groups,and compare the occurrence of adverse reactions in the 3 groups.Results There was no significant difference in operation time,anesthesia time and recovery time among the three groups.The mean arterial pressure(MAP),heart rate(HR)and bispectral index(BI)of middle dose group and high dose group were lower than those of low dose group at the moment when fiberoptic bronchoscope passed through glottis and protuberance(P<0.05);the BI of middle dose group and high dose group was lower than that of low dose group at the moment when fiberoptic bronchoscope was withdrawn(P<0.05).The incidence of adverse reactions in the low dose group was 15.00%,and neither the middle-dose group nor the high-dose group had any adverse reactions,the difference in the incidence of adverse reactions among the three groups

关 键 词：瑞芬太尼 不同剂量 全麻 经喉罩纤支镜手术 不良反应 

分 类 号：R614.2[医药卫生—麻醉学]