瑞芬太尼复合右美托咪定在无痛纤支镜检查中的应用

Application of remifentanil combined with dexmedetomidine in painless fiberoptic bronchoscopy

目的探讨瑞芬太尼复合右美托咪定在无痛纤维支气管镜(简称纤支镜)检查中的临床应用效果。方法进行支气管镜检查的80例患者,随机分为实验组和对照组,每组40例。实验组采用瑞芬太尼复合右美托咪定进行麻醉,对照组采用右美托咪定进行麻醉。记录患者入室时(T0)、麻醉前(T1)、麻醉诱导后(T2)、纤支镜通过声门时(T3)、镜检中(T4)、镜检后(T5)5个时间点的心率(HR)、平均动脉压(MAP)和脉搏氧饱和度(Sp O2);记录镜检过程中不良反应情况并调查患者满意度。结果与对照组相比,实验组患者起效快、检查中不良反应少、血流动力学稳定、患者满意度高,差异均具有统计学意义(P<0.05)。结论瑞芬太尼复合右美托咪定用于纤维支气管镜检查安全有效,值得临床推广。

Objective To explore the clinical application effect of remifentanil combined with dexmedetomidine in painless fiberoptic bronchoscopy. Methods A total of 80 patients receiving painless fiberoptic bronchoscopy were randomly divided into experimental group and control group, and each group contained 40 cases. The experimental group received remifentanil combined with dexmedetomidine for anesthesia, and the control group received dexmedetomidine for anesthesia alone. The data of heart rate（HR）, mean arterial pressure（MAP）, and pulse oxygen saturation（Sp O2） were recorded at the time points including pre-operation（T0）, pre-anesthesia（T1）, post- anesthesia induction（T2）, bronchoscope through glottis（T3）, during intubation（T4） and after intubation（T5）. Adverse reactions during intubation were recorded to investigate patients＇ satisfaction. Results Compared with the control group, the experimental group has quicker anesthetic effect, fewer adverse reaction during intubation, more stable haemodynamics, and higher satisfaction. The difference had statistical significance（P〈0.05）. Conclusion The combination of remifentanil and dexmedetomidine is effective and safe in painless fiberoptic bronchoscopy, and it is worth clinical promotion.