环泊酚用于老年患者无痛纤维支气管镜检查的有效性及安全性  

Efficacy and safety observation of ciprofol for painless fiber bronchoscopy in elderly patients

作　　者：李红新[1] 肖海浩[1] 杨仁[1] 何婉雯 梅倩雯 余晓靖 肖泽林[1] 周丽梅 LI Hongxin;XIAO Haihao;YANG Ren;HE Wanwen;MEI Qianwen;YU Xiaojing;XIAO Zelin;ZHOU Limei(Department of Anesthesiology,Guangzhou Chest Hospital,Guangzhou 510095,Guangdong,China)

机构地区：[1]广州市胸科医院麻醉科,广东广州510095

出　　处：《实用医学杂志》2025年第8期1217-1223,共7页The Journal of Practical Medicine

基　　金：广东省医学科学技术研究基金项目(编号:A2020183);广州地区临床高新、重大和特色技术(2023-2025年)项目(编号:2023C-TS30)。

摘　　要：目的观察环泊酚在老年患者无痛纤维支气管镜检查中的麻醉效果并评估其安全性。方法选取在镇静麻醉下行纤维支气管镜检查的老年患者(≥65岁)96例,随机均分为环泊酚组(C组)和丙泊酚组(P组),每组48例。C组患者麻醉诱导采用舒芬太尼注射液0.1μg/kg、环泊酚0.3 mg/kg,P组患者麻醉诱导采用舒芬太尼注射液0.1μg/kg、丙泊酚中/长链脂肪乳注射液1.5 mg/kg。记录两组患者麻醉前(T_(1))、纤维支气管镜进入声门即刻(T_(2))、纤维支气管镜进至隆突时(T_(3))、检查结束纤维支气管镜离开患者鼻孔即刻(T_(4))、完全清醒离开复苏室时(T_(5))的心率(HR)、平均动脉压(MAP)和血氧饱和度(SpO_(2));记录两组患者镇静麻醉成功率、呛咳评分、诱导时间(t_(1))、纤维支气管镜检查时间(t_(2))、苏醒时间(t3)、定向力恢复时间(t_(4));记录两组患者术中低血压、低氧血症(SpO_(2)<90%)、诱导时注射痛、气道干预(托下颌、面罩通气)以及术中追加镇静药物次数。结果与T_(1)比较,两组患者在T_(2)、T_(3)时MAP均有下降(P<0.05);与P组比较,C组在T_(2)、T_(3)时MAP高于P组(P<0.05);两组患者镇静成功率、诱导时间、呛咳评分、检查时间、苏醒时间、定向力恢复时间差异无统计学意义(P>0.05);与P组比较,C组患者低血压、低氧血症、注射痛发生率及气道干预次数均低于P组(P<0.05)。结论环泊酚联合舒芬太尼用于老年患者镇静麻醉下行纤维支气管镜检查,相较于丙泊酚,环泊酚循环稳定性良好,呼吸相关不良反应及注射时疼痛发生率明显降低,可安全有效地用于老年患者无痛纤维支气管镜诊疗。Objective To evaluate the safety and efficacy of ciprofol in the anesthesia of elderly patients undergoing bronchoscopy.Methods A total of 96 elderly patients(≥65 years old)undergoing fiberoptic bronchos-copy under sedation and anesthesia were randomly assigned to either the ciprofol group(Group C,n=48)or the propofol group(Group P,n=48).In Group C,anesthesia was induced with an intravenous injection of sufentanil at 0.1µg/kg and ciprofol at 0.3 mg/kg.In Group P,anesthesia was induced with an intravenous injection of sufent-anil at 0.1µg/kg and propofol medium/long-chain fat emulsion at 1.5 mg/kg.Hemodynamic parameters,including heart rate(HR),mean arterial pressure(MAP),and peripheral oxygen saturation(SpO_(2)),were recorded at five time points:before anesthesia induction(T_(1)),immediately after the bronchoscope passed through the glottis(T_(2)),immediately after it reached the carina(T_(3)),immediately after the bronchoscope was withdrawn from the nostril post-procedure(T_(4)),and upon full consciousness after leaving the recovery room(T_(5)).Additionally,the success rate of sedation and anesthesia,cough severity scores,induction time(t_(1)),bronchoscopy duration(t_(2)),recovery time(t3),and orientation recovery time(t_(4))were documented for both groups.Intraoperative complications,such as hypotension,hypoxemia(SpO_(2)<90%),injection pain during induction,airway interventions(e.g.,jaw support,mask ventilation),and the number of additional sedative doses administered,were also recorded.Results Compared with T_(1),MAP in both groups decreased at T_(2) and T_(3)(P<0.05).Compared with group P,group C exhibited a higher MAP at T_(2) and T_(3)(P<0.05).between the two groups in terms of sedation success rate,induction time,cough score,examination time,recovery time,and orientation recovery time(P>0.05).Compared with group P,group C demonstrated lower incidences of hypotension,hypoxemia,injection pain,and fewer airway intervention events(P<0.05).Conclusions Compared with propofol,ciprofol in combination with sufe

关 键 词：环泊酚 老年 纤维支气管镜 

分 类 号：R614.2[医药卫生—麻醉学]