目标熵指数指导下苯磺酸瑞马唑仑联合瑞芬太尼麻醉在老年患者喉罩通气下无痛纤维支气管镜检查术中的应用效果研究  

Study on the effect of remazolam benzenesulfonate combined with remifentanil anesthesia under the guidance of target entropy index in patients undergoing painless fiberoptic bronchoscopy with laryngeal mask ventilation

作　　者：陈伟祥 覃述 金纯纳 李先花 苏立新 CHEN Wei-xiang;QIN Shu;JIN Chun-na(Zhuhai Fifth People's Hospital,Zhuhai 519055,China)

机构地区：[1]珠海市第五人民医院,519055

出　　处：《中国实用医药》2024年第22期16-20,共5页China Practical Medicine

基　　金：2023年度珠海市医学科研项目(项目编号:2220009000225)。

摘　　要：目的 考察目标熵指数指导下苯磺酸瑞马唑仑联合瑞芬太尼麻醉在老年患者喉罩通气下无痛纤维支气管镜检查术中的应用效果。方法 选取80例择期行喉罩通气下无痛纤维支气管镜诊疗的老年患者,采用随机数字表法分为观察组(40例)、对照组(40例)。观察组在目标熵指数指导下给予苯磺酸瑞马唑仑联合瑞芬太尼麻醉,对照组在目标熵指数指导下给予丙泊酚联合瑞芬太尼麻醉。比较两组镇静成功率、检查时间和恢复时间,不同时间点[麻醉前(即平静吸氧5 min后,T0),麻醉诱导完成即刻(T1)、内镜进入声门即刻(T2)、内镜抵达隆突即刻(T3)、检查过程中(即麻醉诱导完成后10 min,T4)、镜检结束即刻(T5)、出室即刻(T6)]血流动力学及呼吸功能相关指标[平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼吸频率(RR)及状态熵(SE)],术中不良事件发生情况,术后不良反应发生情况。结果 两组患者镇静成功率、检查时间和恢复时间比较,差异均无统计学意义(P>0.05)。两组T1、T2、T3、T4、T5、T6时MAP和SE均低于T0时(P<0.05);观察组T3、T4、T5、T6时MAP分别为(96.96±6.90)、(96.18±7.03)、(96.33±7.52)、(94.35±6.32)mm Hg(1 mm Hg=0.133 kPa),均高于对照组的(93.13±7.47)、(92.44±7.72)、(92.79±8.03)、(91.10±7.54)mm Hg(P<0.05)。观察组术中不良事件发生率5.00%低于对照组的20.00%(P<0.05)。两组术后不良反应发生率比较,差异无统计学意义(P>0.05)。结论 目标熵指数指导下苯磺酸瑞马唑仑联合瑞芬太尼对老年患者喉罩通气下无痛纤维支气管镜检查术的全麻诱导及术中维持效果较好,镇静成功率高,术中对血流动力学及呼吸功能影响较小,并发症较少。Objective To investigate the application effect of remazolam benzenesulfonate combined with remifentanil anesthesia under the guidance of target entropy index in patients undergoing painless fiberoptic bronchoscopy with laryngeal mask ventilation.Methods A total of 80 elderly patients who received painless fiberoptic bronchoscopy under laryngeal mask ventilation were selected and divided into an observation group(40 cases) and a control group(40 cases) by random numerical table.The observation group was given remazolam benzenesulfonate combined with remifentanil anesthesia under the guidance of target entropy index,and the control group was given propofol combined with remifentanil anesthesia under the guidance of target entropy index.Both groups were compared in terms of success rate of sedation,examination time and recovery time,hemodynamic and respiratory function-related indexes [mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO2),respiratory rate(RR),and state entropy(SE)] at different time points [before anesthesia(i.e.,5 min after calm oxygen inhalation,T0),immediately after anesthesia induction(T1),immediately after endoscopic entry into the vocal folds(T2),immediately after arrival of the endoscope at the ronchi(T3),during the examination(i.e.,10 min after anesthesia induction,T4),immediately after the examination(T5),and immediately after exit from the room(T6)],as well as the occurrence of intraoperative adverse events and postoperative adverse reactions.Results There was no significant difference in the success rate of sedation,examination time and recovery time between the two groups(P>0.05).MAP and SE at T1,T2,T3,T4,T5 and T6 in both groups were lower than those at T0(P<0.05).MAP of the observation group were(96.96±6.90),(96.18±7.03),(96.33±7.52) and(94.35±6.32) mm Hg(1 mm Hg=0.133 kPa) at T3,T4,T5 and T6,which were higher than(93.13±7.47),(92.44±7.72),(92.79±8.03) and(91.10±7.54) mm Hg of the control group(P<0.05).The incidence of adverse events of 5.00%in the observati

关 键 词：无痛纤维支气管镜检查术 喉罩通气 苯磺酸瑞马唑仑 瑞芬太尼 目标熵指数 麻醉 老年 

分 类 号：R614[医药卫生—麻醉学]