无痛苦纤维支气管镜检查技术的临床应用

Clincal application of painless fibreoptic bronchoscopy

目的探讨芬太尼联合丙泊酚复合麻醉在纤维支气管镜检查中的安全性、舒适性。方法 62例患者随机分组,局部表面麻醉组(Ⅰ组)29例,芬太尼联合丙泊酚静脉麻醉组(Ⅱ组)33例。记录支气管镜检查术前、术中、术后心率、收缩压、脉搏氧饱和度、动脉血氧分压和气管镜操作时间以及不良反应,填写检查问卷。结果Ⅱ组术中心率、收缩压、脉搏氧饱和度波动小,气管镜操作时间短,与Ⅰ组相比差异有显著性(P<0.05);两组术后心率、收缩压、脉搏氧饱和度、动脉血氧分压与术前比较差异无显著性(P>0.05)。Ⅱ组可接受再次检查比率(75.8%)明显高于Ⅰ组(30.1%)。结论芬太尼联合丙泊酚复合麻醉的支气管镜检查安全,患者舒适性好。

[Objectives] To investigate the safety and comfort of fentanyl and propofol combinations for intravenous anesthesia in fiberoptic bronchoscopy.[Methods] 62 cases undergone fiberoptic bronchoscopy were randomly assigned to receive local surface anesthesia（group Ⅰ,n =29）,or intravenous anesthesia by fentanyl and propofol combinations（group Ⅱ,n =33）.We measured heart rate（HR）,systolic blood pressure（SBP）,pulse oxygen saturation（SpO2） and arterial oxygen pressure（PaO2） during the preoperative,perioperative and postoperative stage respectively,recorded operation duration,observed adverse events and carried out questionnaire on patients.[Results] In the perioperative stage,the group Ⅱ showed little change in HR,SBP and SPO2 compared with the group Ⅰ（P 0.05）.The duration of operation of the groupⅡ was significantly shorter than that in the group Ⅰ（P 0.05）.After operation,HR,SBP,SPO2 and PaO2 did not show a significant difference between the two groups in change from baseline（P 0.05）.Patients who could receive repeated fiberoptic bronchoscopy were 75.8% in the group Ⅱ compared with 30.1% in the group Ⅰ.[Conclusion] Fentanyl and propofol combinations for intravenous anesthesia is safety and can improve comfort in painless fiberoptic bronchoscopy.