右旋美托咪啶复合靶控输注瑞芬太尼用于纤维支气管镜检查的临床研究

发布时间：2018-04-17 10:55

本文选题：右旋美托咪啶 + 瑞芬太尼　；参考：《中国内镜杂志》2015年06期

【摘要】：目的研究右旋美托咪啶(D ex)复合靶控输注瑞芬太尼在纤维支气管镜检查中的应用效果。方法选择择期行纤维支气管镜检查的住院患者40例,随机分为两组:D ex复合靶控输注瑞芬太尼组(D R组),丙泊酚复合瑞芬太尼靶控输注组(PR组)。记录麻醉前(T 0)、静脉输注D ex后(PR组输注等量生理盐水)10 m in(T 1)、纤支镜进入前(T 2)、进镜至声门部(T 3)、气管内(T 4)及术毕(T 5)、术毕10 m in(T 6)、术毕20 m in(T 7)时的血压(M A P)、心率(H R)和脉搏氧饱和度(SPO2)及N T值。观察期间有无呛咳、气道痉挛、体动、低血压及心动过缓等不良反应。结果与基础值(T 0)相比,D R组M A P及H R T 2及T 6降低(P0.05)。与D R组及T 0相比,PR组M A P及H R于T 2时降低(P0.05。D R组N T值于T 1、T 6低于于PR组。D R组低血压、呛咳例数及面罩人工辅助通气的次数少于PR组。结论 D ex复合靶控输注瑞芬太尼能为纤支镜检查提供较好的镜检条件,不良反应少,呼吸抑制作用弱,为纤支镜检查的一种较理想的麻醉方式。
[Abstract]:Objective to study the effect of dexmetimetidine combined with target controlled infusion of remifentanil in fiberoptic bronchoscopy.Methods Forty inpatients who underwent fiberoptic bronchoscopy were randomly divided into two groups: group D (n = 10) with remifentanil plus remifentanil (n = 40) and group PR (n = 10) with propofol combined with remifentanil (TCI).The blood pressure was recorded before anesthesia and after intravenous infusion of 10 m in(T of normal saline in PR group. The blood pressure was obtained by fiberoptic bronchoscopy to the glottis T3, T4) and T5, 10 m in(T 6 after operation and 20 m in(T 7 at the end of operation.M A Pe, HR H R), pulse oxygen saturation, SPO 2) and N T values.There were adverse reactions such as cough, airway spasm, body movement, hypotension and bradycardia.Results compared with the basic value of T _ 0), M A P, H R T 2 and T 6 in D R group were significantly lower than those in D R group (P 0.05).Compared with D R group and T 0 group, M A P and H R in PR group were lower than those in PR group at T 2. The N T value of P 0.05 D R group was lower than that of PR group .D R group was lower than PR group (P < 0.01), the number of cough cases and the times of mask assisted ventilation were less than those in PR group.Conclusion Dex combined with target-controlled infusion of remifentanil can provide better conditions for fiberoptic bronchoscopy with less adverse reactions and weak respiratory inhibition. It is an ideal anaesthesia for fiberoptic bronchoscopy.
【作者单位】：广东佛山市禅城区中心医院麻醉科;
【分类号】：R614

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