芬太尼静脉复合全麻用于婴幼儿支气管镜检术效果分析

Effectiveness analysis of fentanyl combined with propofol and midazolam anesthesia in infants undergoing bronchoscopy

目的探讨芬太尼静脉复合全麻用于婴幼儿支气管镜检术的效果。方法将458例需行支气管镜检术的患儿分为两组,分别采用芬太尼(F组)静脉复合全麻和氯胺酮(K组)静脉复合全麻。记录两组患儿麻醉诱导后、置镜前及术中3个时间点的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)及动脉血氧饱和度(SpO2)变化。观察麻醉效果及并发症发生率。结果两组麻醉方法 均能满足手术要求,但与F组比较,K组术中HR、MAP及RR明显增高(P<0.01);SpO2明显降低(P<0.01)。F组严重缺氧、屏气等并发症发生率明显低于K组。结论芬太尼无心血管兴奋作用,镇痛效果强,单次注射作用维持时间比氯胺酮长,只要掌握好推注速度和充分吸氧,可避免肌僵和缺氧的发生,且能保障患儿术中生命体征的平稳,保证手术顺利进行。

Objective To investigate the effect of different anesthetic methods on bronchoscopy in infants. Methods Four hun- dred and fifty-eight infants undergoing bronehoscopy were divided into two groups. The patients in the group F were treated with fentanyt intravenous anesthesia, the group K were treated with ketamine intravenous anesthesia. The change of the mean artery pressure（ MAP）, heart rate（ H R）, breathing rate（RR）, saturation of arterial blood oxygen（SpO2 ） in each group were recorded after induction of anesthesia, before the examination and during the examination. The effect of anesthesia and the incidence of complica- tions were observed. Results Anesthesia succeeded in both ways. However the patients in group K had higher HR,MAP and RR, lower Sp（）2 compared with those in group F（P^0.01）. The complications such as anoxia and breathholding occurred less frequent- ly in F group patients than in K group patients. Conclusion Fentanyl does not play a role in vessel activity and has strong analgesic effectiveness which could maintain longer than ketamine in single dose. Muscle stiffness and hypoxemia could be avoided in controlling injection rate strictly and.oxygen uptake sufficiently. Fentanyl would assist to ensure the infants experience bronchoscopy in stable vital sign.