不同剂量地佐辛复合异丙酚在支纤镜检查中的临床应用

Clinic Application of Different Doses of Dezocine Combined with Propofol in Fiberoptic Bronchoscopy

目的观察不同剂量地佐辛复合异丙酚在支纤镜检查中的麻醉效果及其对患者呼吸、循环影响,为无痛支气管镜检查提供安全有效的麻醉方法.方法将80例ASA分级Ⅰ-Ⅱ级纤维支气管镜检查的患者随机分为4组各20例.A组予地佐辛100μg/kg,B组予地佐辛150μg/kg,C组予地佐辛200μg/kg,D组予芬太尼2μg/kg;4组患者术中均辅以2μg/mL的异丙酚靶控持续输注.观察4组患者的术中监测血压(BP)、心率(HR)、血氧饱和度(SpO)2、心电图(ECG)和体征情况.比较呼吸、循环稳定性,记录苏醒后的VAS和Ramsay评分和恶心、烦躁等不良反应的发生率.结果 C组患者在进入声门检查及活检时HR与A、B、D组患者间差别有统计学意义(P<0.05);C组患者在进入声门及检查时SpO2、RR与A、B、C组间差异有统计学意义(P<0.05).4组患者的麻醉效果及不良反应发生率间,差异有统计学意义(P<0.05).结论异丙酚复合200μg/kg地佐辛应用于纤维支气管镜检查可获得满意的麻醉效果,二药搭配合用的平衡麻醉镇痛模式合理,麻醉更安全平稳,并发症及不良反应更少.

Objective To observe the anesthetic effect and its effects on patients＇ respiration and circulation of different doses of dezocine combined with propofol in fiberoptic bronchoscopy.Methods Eighty patients with ASA gradeⅠ-Ⅱ in fiberoptic bronchonscopy were randomly assigned to 4 groups,each group 20 patients.Groups A,B,C and D were treated with 100 μg/kg dezocine,150 μg/kg dezocine,200 μg/kg dezocine and 2 μg/kg fentanyl,respectively.All patients were continuous target controlled infusion with 2 μg/mL propofol.The blood pressure（BP）,heart rate（HR）,oxygen saturation degree（SpO）2,electrocardiogram（ECG） and signs were recorded.The respiratory and circulatory of all groups were compared.And VAS,Ramsay and score adverse reactions such as nausea and dysphoria were examined after awakening.Results During glottis examination and biopsy,HR and SpO2 of group C were significantly different from that of groups A,B and D（P0.05）.The anesthetic effect and the incidence of adverse effects of four groups were all different statistically（P0.05）.Conclusions The application of 200 μg/kg dezocine combined with propofol in fiberoptic bronchoscopy could provide satisfactory anesthetic effect.The balanced anesthesia analgesia regimen has the advantages of more security and stable,less complication and adverse reactions.