阿芬太尼联合瑞马唑仑在无痛支气管镜检查中的镇静镇痛效果研究  

Sedative and analgesic effects of alfentanil combined with remiazolam in painless bronchoscopy

作　　者：宋海龙 贾雅蕊[2] 武复召 鲁立军 SONG Hai-long;JIA Ya-rui;WU Fu-zhao;LU Li-jun(Anesthesia Operation Department and Anesthesia and Pain Diagnosis and Treatment Center,Caoxian People's Hospital,Heze 274400,Shandong,CHINA;Department of Anesthesia,Heze Municipal Hospital,Heze 274031,Shandong,CHINA)

机构地区：[1]曹县人民医院麻醉手术部、麻醉与疼痛诊疗中心,山东菏泽274400 [2]菏泽市立医院麻醉科,山东菏泽274031

出　　处：《海南医学》2023年第15期2187-2190,共4页Hainan Medical Journal

基　　金：中国红十字基金会医学赋能公益专项基金(编号:CRCF-YXFN-202201060);山东省医学会镇痛镇静优化专项资金(编号:YXH2021ZX033)。

摘　　要：目的研究阿芬太尼联合瑞马唑仑在无痛支气管镜检查中的镇静镇痛效果。方法选择2020年3月至2022年10月在曹县人民医院行无痛支气管镜检查的100例患者纳入研究,按照抽签法分为研究组和对照组各50例。对照组患者采用丙泊酚联合阿芬太尼麻醉,研究组患者采用阿芬太尼联合瑞马唑仑麻醉。比较两组患者术中情况(麻醉开始至检查开始时间、检查时间、苏醒时间、自主呼吸恢复时间)和T0(诱导前1~3 min)、T1(诱导后1 min)、T2(进镜时)、T3(诱导后2 min)、T4(诱导后3 min)、T5(诱导后5 min)、T6(检查结束时)的平均动脉压和心率,并比较两组患者术中及术后不良反应发生率。结果两组患者麻醉开始至检查开始时间、检查时间、苏醒时间、恢复自主呼吸时间比较差异均无统计学意义(P>0.05);麻醉后,两组患者的平均动脉压和心率均较麻醉前下降,研究组患者T3、T4的平均动脉压分别为(88.09±8.56)mmHg、(90.02±9.09)mmHg,明显高于对照组同时点的(82.89±5.68)mmHg、(83.01±5.70)mmHg,T2、T3、T4的心率分别为(77.06±12.83)min、(77.62±12.85)min、(76.18±13.62)min,明显高于对照组同时点的(70.98±6.72)min、(70.86±6.65)min、(69.39±6.61)min,差异均有统计学意义(P<0.05);研究组患者的不良反应总发生率为10.00%,明显低于对照组的26.00%,差异有统计学意义(P<0.05)。结论阿芬太尼联合瑞马唑仑应用于无痛支气管镜检查中,其镇静镇痛效果显著,不会造成较大的呼吸循环抑制,且可有效维持血压稳定,缩短术后苏醒时间,降低不良反应发生率,安全可靠。Objective To study the sedative and analgesic effects of alfentanil combined with remiazolam in painless bronchoscopy.Methods One hundred patients undergoing painless bronchoscopy in Caoxian People's Hospital from March 2020 to October 2022 were selected for this study.According to the method of drawing lots,they were divided into study group and control group,with 50 patients in each group.The control group was anesthetized with propofol and alfentanil.The study group was anesthetized with alfentanil and remiazolam.The two groups were compared in intraoperative conditions(time from the beginning of anesthesia to the beginning of examination,examination time,awakening time,and autonomous breathing recovery time),the changes in mean arterial pressure and heart rate at time points T0(1-3 minutes before induction),T1(1 minute after induction),T2(at endoscopy),T3(2 minutes after induction),T4(3 minutes after induction),T5(5 minutes after induction),and T6(at the end of examination).The incidence of intraoperative and postoperative adverse reactions between the two groups of patients were compared.Results There was no significant difference between the two groups of patients in the time from the beginning of anesthesia to the beginning of examination,examination time,awakening time,and autonomous breathing recovery time(P>0.05).The mean arterial pressure and heart rate of the two groups of patients after anesthesia were lower than those before anesthesia,the mean arterial pressure of T3 and T4 in the study group was(88.09±8.56)mmHg and(90.02±9.09)mmHg,which were significantly higher than(82.89±5.68)mmHg,(83.01±5.70)mmHg in the control group,respectively(P<0.05).The heart rates at T2,T3,and T4 of the study group were(77.06±12.83)min,(77.62±12.85)min,(76.18±13.62)min,which were significantly higher than(70.98±6.72)min,(70.86±6.65)min,(69.39±6.61)min in the control group,respectively(P<0.05).The total incidence of adverse reactions in the study group was 10.00%,which was significantly lower than 26.00%in the co

关 键 词：无痛支气管镜 阿芬太尼 瑞马唑仑 镇痛效果 并发症 

分 类 号：R614[医药卫生—麻醉学]