瑞马唑仑-阿芬太尼-米库氯铵联合运用于儿童纤维支气管镜检查术的麻醉效果评定  

Evaluation of the anaesthetic effect of the combination of remimazolam-alfentanil-mivacurium in pediatric fiberoptic bronchoscopy

作　　者：胡德铭 甘露平 王胜强 尹琳 黄爱莲 廖梅 HU Deming;GAN Luping;WANG Shengqiang;YIN Lin;HUANG Ailian;LIAO Mei(Yichun People's Hospital,Yichun 336000,China)

机构地区：[1]宜春市人民医院,江西宜春336000

出　　处：《临床医药实践》2025年第3期190-194,共5页Proceeding of Clinical Medicine

基　　金：宜春市指导性科技计划项目(项目编号:JXYC2024KSA009)。

摘　　要：目的:研究瑞马唑仑-阿芬太尼-米库氯铵联合用于儿童纤维支气管镜(简称纤支镜)检查术的麻醉效果及安全性。方法:选取宜春市人民医院2024年4月-2024年8月行纤维支气管镜检查术的患儿80例,随机分为R组和B组,每组40例。R组联合使用瑞马唑仑-阿芬太尼-米库氯铵麻醉诱导。B组联合使用丙泊酚-芬太尼-苯磺顺阿曲库铵麻醉诱导。记录两组患儿麻醉诱导前(t_(0))、置入喉罩时(t_(1))、纤支镜到隆突时(t_(2))、手术开始10 min(t_(3))、手术结束时(t_(4))和患儿清醒时(t_(5))的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))、呼气末二氧化碳分压(P_(ET)CO_(2))。比较两组患儿麻醉诱导时是否有呛咳、术后苏醒时间、镇静效果(Ramsay)评分、肌张力恢复程度以及呼吸抑制、恶心呕吐、躁动等不良反应发生率。结果:R组患儿术中MAP,HR水平在t_(1),t_(2),t_(3),t_(4)优于B组,SpO_(2)和P_(ET)CO_(2)在t_(5)优于B组,差异有统计学意义(P<0.05)。R组患儿诱导时呛咳、术后苏醒时间、Ramsay评分、肌张力恢复程度及不良反应发生率均小于B组,差异有统计学意义(P<0.05)。结论:瑞马唑仑-阿芬太尼-米库氯铵联合用于儿童纤维支气管镜检查术的麻醉效果具有可行性及优越性,与丙泊酚-芬太尼-苯磺顺阿曲库铵相比,麻醉诱导时呛咳发生率低,术中血流动力学平稳,镇静程度高,肌张力好,术后苏醒迅速,恶心呕吐、躁动和呼吸抑制等不良反应发生率低,可有效改善患儿预后,提高患儿围术期麻醉安全和舒适度。Objective:To study the characteristics and safety of anaesthetic effect of the combination of remimazolam-alfentanil-mivacurium in pediatric fiberoptic bronchoscopy.Methods:Eighty children who would undergo fiberoptic bronchoscopy in yichun people's hospital from April 2024 to August_(2)024 were selected,and the patients were divided into Group R(remimazolam-alfentanil-mivacurium),and Group B(propofol-fentanyl-benzenesulfonium atracurium)(n=40)by using the random number table method.Mean arterial pressure(MAP),heart rate(HR),blood pressure saturation(SpO_(2)),and partial pressure of end-expiratory carbon dioxide(P_(ET)CO_(2))were recorded at each time point before induction of anaesthesia(t_(0)),at the time of placing the laryngeal mask(t_(1)),at the time of fibrinoscopy to the tracheal bulge(t_(2)),at the beginning of the surgery for 10 min(t_(3)),at the end of the surgery(t_(4)),and when the children were awake(t_(5))in two groups were compared.The incidence of adverse reactions such as the presence of choking during induction of anaesthesia,postoperative awakening time,degree of sedation(Ramsay score),degree of recovery of muscle tone,and the incidence of adverse reactions such as respiratory depression,nausea and vomiting,and agitation in two groups were compared.Results:It was found that intraoperative MAP and HR levels of children in group R were better than those in group B at t_(1),t_(2),t_(3)and t_(4),and SpO_(2)and P_(ET)CO_(2)were better than those in group B at t_(5),with statistically significant differences(P<0.05).The incidence of adverse reactions such as choking during induction,postoperative awakening time,Ramsay score,degree of recovery of muscle tone,degree of nausea and vomiting agitation,and respiratory depression in the children in group R were smaller than those in group B,and the differences were all statistically significant(P<0.05).Conclusion:The anaesthesia effect of the combination of remimazolam-alfentanil-mivacurium in paediatric fibreoptic bronchoscopy is feasible and superior.Comp

关 键 词：瑞马唑仑 阿芬太尼 米库氯铵 儿童 纤维支气管镜检查 

分 类 号：R614[医药卫生—麻醉学]