盐酸羟考酮联合丙泊酚用于无痛纤支镜麻醉的效果  

Effect of oxycodone hydrochloride combined with propofol in fiberoptic bronchoscopy

作　　者：蒋维香 邱燕[1] 魏小珍 张娇[1] 李雪寒 韩青兵 王儒蓉[1] JIANG Weixiang;QIU Yan;WEI Xiaozhen;ZHANG Jiao;LI Xuehan;HAN Qingbing;WANG Rurong(Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Respiratory,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院麻醉科,四川成都610041 [2]四川大学华西医院呼吸科,四川成都610041

出　　处：《西部医学》2022年第12期1812-1816,共5页Medical Journal of West China

基　　金：国家自然科学基金(81900064)。

摘　　要：目的研究盐酸羟考酮应用在无痛纤支镜麻醉中的麻醉效果。方法选取2021年5月~2022年3月我院接受纤支镜检查的患者85例,采用随机数字表法将患者随机分为对照组(舒芬太尼联合丙泊酚,n=42)和观察组(盐酸羟考酮联合丙泊酚,n=43)。观察两组患者围术期血流动力学指标、围术期的咳嗽和躁动评分以及术后的镇静和疼痛评分。记录术中麻醉药用量及不良反应发生率,并评估患者和术者的满意度。结果两组患者基线一致,观察组追加舒芬太尼的例数明显少于对照组,但观察组的麻醉苏醒时间较对照组明显延长(P<0.01)。纤支镜经过气管隆突或狭窄处时两组患者的心率和平均动脉压明显升高,且对照组显著高于观察组(P<0.05)。观察组术中的咳嗽评分和躁动评分均显著低于对照组(P<0.05)。观察组的镇静评分和疼痛视觉模拟评分(VAS)显著低于对照组(P<0.05),且术后半小时的VAS评分仍显著低于对照组(P<0.05)。两组患者不良事件发生率比较差异无统计学意义(P>0.05),但观察组患者和术者的满意度显著高于对照组(P<0.05)。结论盐酸羟考酮较舒芬太尼在纤支镜检查中具有更好的镇痛效果,血流动力学更稳定,减少了患者术中的躁动和咳嗽以及术中追加麻醉药用量,明显提高了患者和术者的满意度。Objective To study the anesthetic effect of oxycodone hydrochloride in painless fiberoptic bronchoscopy anesthesia.Methods 85 patients who underwent fiberoptic bronchoscopy from May 2021 to March 2022 were randomly divided into control group(sufentanil+propofol,n=42)and experimental group(oxycodone hydrochloride+propofol,n=43).The perioperative hemodynamic indexes,perioperative cough and agitation scores,postoperative sedation and pain scores were recorded,and the intraoperative anesthetic dosage and incidence of adverse events were recorded,and the satisfaction of patients and operators was evaluated.Results The baseline of the two groups was the same.The times of sufentanil administration in the experimental group was significantly less than that in the control group,but the recovery time in the experimental group was significantly longer than that in the control group(P<0.01).The heart rate and mean arterial pressure were significantly increased when the fiberoptic bronchoscope passed through the tracheal carina or stenosis(T3),and they were significantly higher in control group than those of the experimental group(P<0.05).The scores of cough and agitation in the experimental group were significantly lower than those in the control group(P<0.05).The cough score,Ramsay score and visual analogue scale(VAS)score of the experimental group were significantly lower than those of the control group(P<0.05),and the VAS score of half an hour after operation was still significantly lower than that of the control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups,but the satisfaction of both patients and operators in the experimental group was significantly higher than that in the control group(P<0.05).Conclusion Oxycodone hydrochloride has better analgesic effect and more stable hemodynamics than sufentanil during fiberoptic bronchoscopy,it significantly reduced patients'agitation,cough and administration of anesthetics during operation,and significantly improved s

关 键 词：盐酸羟考酮 舒芬太尼 无痛纤支镜检查 咳嗽 

分 类 号：R614[医药卫生—麻醉学]