阿芬太尼复合丙泊酚对无痛纤维支气管镜检查的麻醉效果  

Effect of alfentanil combined with propofol for painless fiberoptic bronchoscopy

作　　者：马亚[1] 刘绍正 乔伟[1] 王先锋[1] MA Ya;LIU Shao-zheng;QIAO Wei;WANG Xian-feng(Department of Anesthesiology,Wanbei Coal and Electricity Group General Hospital,Suzhou 234011,Anhui,China)

机构地区：[1]皖北煤电集团总医院麻醉科,安徽宿州234011

出　　处：《川北医学院学报》2023年第7期961-964,共4页Journal of North Sichuan Medical College

基　　金：安徽省宿州市科技局项目(SZSKJJZC2020031)。

摘　　要：目的:探讨阿芬太尼复合丙泊酚对无痛纤维支气管镜检查的麻醉效果。方法:选取196例拟行无痛纤维支气管镜检查术的患者为研究对象,依据麻醉诱导方式不同将患者分为对照组与试验组,每组各98例。对照组患者予以舒芬太尼0.1μg/kg麻醉诱导;试验组患者予以阿芬太尼10μg/kg麻醉诱导;同时,两组患者均给予丙泊酚1~2 mg/kg和氯化琥珀胆碱1~2 mg/kg。比较两组患者入室静卧10 min(T0)、意识消失时(T1)、置入喉罩时(T2)、进镜检查即刻(T3)、检查开始后2 min(T4)、检查开始后4 min(T5)和检查结束即刻(T6)的心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO_(2))、恢复情况及不良反应发生情况。结果:T0时,两组患者HR、MAP比较,差异无统计学意义(P>0.05);T1、T3、T4时,两组患者HR、MAP均较T0时降低(P<0.05),试验组T1时的HR、MAP高于对照组(P<0.05)。两组患者各时点SpO_(2)水平比较,差异无统计学意义(P>0.05)。试验组恢复自主呼吸、拔除喉罩和离开PACU时间均短于对照组(P<0.05);呛咳发生发生率及术后恶心呕吐发生率低于对照组(P<0.05)。结论:阿芬太尼复合丙泊酚用于无痛纤维支气管镜检查可获得较好麻醉效果,患者血流动力学波动小,术后恢复快,且可减少呛咳反应的发生。Objective:To investigate the effect of alfentanil combined with propofol in painless fiberoptic bronchoscopy.Methods:196 patients undergoing painless fiberoptic bronchoscopy were divided into control group and experimental group according to the different anesthesia induction methods,98 cases in each group.Anesthesia was induced with sufentanil 0.1μg/kg in the control group and alfentanil 10μg/kg in the experimental group.Both groups were given propofol 1~2 mg/kg and succinylcholine chloride 1~2 mg/kg.The heart rate(HR),mean arterial pressure(MAP)and pulse oxygen saturation(SpO 2),and recovery and occurrence of adverse reactions were compared between the two groups at 10 min after entering the room(T0),loss of consciousness(T1),insertion of laryngeal mask(T2),immediately after entering the endoscopy(T3),2 min after the start of the examination(T4),4 min after the start of the examination(T5)and immediately after the end of the examination(T6).Results:At T0,there was no significant difference in HR and MAP between the two groups(P>0.05).At T1,T3 and T4,the HR and MAP of the two groups were lower than those at T0(P<0.05),and the HR and MAP of the experimental group at T1 were higher than those of the control group(P<0.05).There was no significant difference in SpO 2 between the two groups at each time point(P>0.05).The time of spontaneous breathing,removal of laryngeal mask and leaving PACU in group T were shorter than those in control group(P<0.05).Compared with control group,the incidence of cough and postoperative nausea and vomiting in group T was lower(P<0.05).Conclusion:Alfentanil combined with propofol for painless fiberoptic bronchoscopy can obtain better anesthetic effect,with small hemodynamic fluctuations,rapid postoperative recovery,and can reduce the occurrence of cough reaction.

关 键 词：纤维支气管镜 阿芬太尼 丙泊酚 麻醉 呛咳反应 

分 类 号：R614.2[医药卫生—麻醉学]