异丙酚用于无痛苦纤维支气管镜检查的临床观察

Clinical application of painless fibrobronchoscopy

目的采用异丙酚静脉全身麻醉,减轻纤维支气管镜(简称纤支镜)检查的痛苦.方法共70例接受异丙酚静脉麻醉,平均年龄58.47岁.给药剂量1.5-2.0mg/kg,静脉注射速度30mg/10 s,待睫毛反射消失后开始镜检.结果异丙酚静脉注射后平均(41.63±7.69)s出现睫毛反射消失,终止注射后平均(5.32±1.98)min出现唤醒反应,完全清醒时间(11.02±2.86)min.异丙酚组在检查前、检查中(给药后)和完全清醒的血压改变为下降趋势,收缩压平均比检查前下降16 mmHg、舒张压下降10 mmHg,但在终止用药后血压逐渐回升至正常.心电图监测未见明显的心肌缺血、心律紊乱.结论异丙酚可用于门诊和住院的儿童、成年、老年病人纤支镜的检查和治疗,用药量一般在2.0mg/kg以内,安全有效,病人均顺利完成无痛苦纤支镜的检查.

[Objective]To relieve pain during fibrobronchoscopy through systemic anesthesia with intravenous injection of Diprivan. Of all the 70 cases, the average age was 58.47 years old. Diprivan was selected at the dosage for 1.5~2.0 mg/kg according to patients′ body weight, injected intravenously at 30 mg per 10 seconds. The fibrobronchoscopy was started after the disappearance of lash reflex. Diprivan took effect quickly. The lash reflex disappeared in (41.63±7.69) seconds in average after intravenous injection, and patients regained consciousness in (5.32±1.98) minutes after stopping injection in average. The time to approach a totally awakening was (11.02±2.86) minutes. The change of blood pressure showed a declining trend from pre- examination, post-injection to complete awakening. The systolic pressure was 16 mmHg less than pre-examination, and the diastolic pressure was 10 mmHg less than pre-examination in average. But the blood pressure rise gradually to normal level after stopping the injection of Diprivan. Electrocardiography monitoring did not show any signs of myocardial ischemia or cardiac disrhythmia during examination. [Conclusions] Diprivan can be used safely in the examination and treatment of fibrobronchoscopy for children, adults and seniors who are either out or in hospital. It will be safety and effective when the dosage is less than 2.0 mg/kg, and patients can finish the examination of painless fibrobronchoscope quite smoothly.