盐酸羟考酮复合丙泊酚在无痛纤维支气管镜检查中的临床应用

Clinical Application of oxycodone compounded with propofol in painless fiber Bronchoscopy

目的探讨盐酸羟考酮复合丙泊酚用于无痛纤维支气管镜检查的临床应用效果。方法选择行无痛纤维支气管镜检查的患者90例,按随机数字表法将患者分为3组:盐酸羟考酮复合丙泊酚组(O组)、芬太尼复合丙泊酚组(F组)和对照组(C组),每组30例。O组麻醉采用羟考酮0.1mg/kg和丙泊酚2.0mg/kg静脉注射,F组麻醉采用芬太尼1.0μg/kg和丙泊酚2.0mg/kg静脉注射,C组静脉注射10ml生理盐水。记录3组患者的检查操作时间、丙泊酚用量,记录麻醉前(T_0)、麻醉后(T_1)、入镜(声门)时(T_2)、入镜2min(T_3)、入镜5min(T_4)、退镜时(T_5)的HR、SpO_2、SBP、DBP,观察3组患者在镜检时的耐受情况及低血压、心动过缓、呼吸抑制等药物不良反应的发生情况,随访患者对麻醉的舒适满意度。结果 O组和F组患者在T_1时HR、SBP、DBP与T_0比较显著下降(P<0.05),C组患者在T_2-T_4时HR、SBP、DBP与T_0比较显著升高,同时点SpO_2与T_0比较显著下降;O组和F组患者在T_1-T_4时HR、SBP、DBP与对照组比较显著下降,SpO_2在T_2-T_4时与对照组比较显著升高;O组和F组患者一次插管成功率显著高于对照组,检查过程中呛咳、屏气、强迫坐起和呼吸抑制的发生率显著低于对照组;O组呛咳、呼吸抑制的发生率明显低于F组;O组和F组患者舒适满意度显著高于对照组。结论盐酸羟考酮复合丙泊酚麻醉可有效地用于纤维支气管镜检查,患者检查时舒适度高,且药物不良反应少。

Objective To observe the clinical effects of oxycodone compounded with propofol in painless fiber bronchoscopy. Methods Ninety patients undergoing painless fiberoptic bronchoscopy were randomly divided into three groups：oxycodone com- pounded with propofol group （Group O）,fentanyl compounded with propofol group （Group F） and control group （Group C）. The pa- tients in group O were administered with 0.1mg. kg-1 oxycodone and 2.0mg.kg-1 propofol,the group F were administered with 1.0 ug. kg-1 fentanyl and 2.0mg. kg-1 propofol,while the control group received 10 ml saline. The operation time,intraoperative propofol consumption were recorded in three groups. Furthermore ,heart rate （HR）, oxygen saturation （SpO2）, systolic blood pressure （SBP）, diastolic blood pressure （DBP） were measured before anesthesia （T0）,immediately after anesthesia （T1）,when insertion （T2）, 2 min- utes after insertion（T3）, 5 minutes after insertion（T4） and when exsertion （T2）. The success rate of one-time insertion, the tolerances, the incidence of adverse reactions of oxycodone （hypotension,bradycardia and respiratory depression） were counted up in three groups, the comfortable satisfaction of anesthesia in three groups were followed-up. Results Compared with To, the HR, SBP, DBP were decreased at T in group O and group F. Compared with T0,the HR, SBP, DBP were increased at T2-T4 in group C,while the SpO2 were decreased at T2-T4. Compared with group C,the HR,SBP,DBP were decreased at T1-T4 in group O and group F,while the SpO2 were increased at TrT4 （P〈0.05）. Compared with group C, the success rate of one-time insertion in group O and group F were significantly increased ,the incidence of bucking, breathholding,forced to sit up ,respiratory inhibition were decreased. Com- pared with group F,the incidence of bucking and respiratory inhibition were significantly decreased. Compared with group C ,the comfort satisfaction of anesthesia were significantly higher in group O and group F （P〈0.05）. Conclusion Oxycodone hydrochlo- ride compounded with propofol can be effectively used for fiber bronchoscopy, patients were examined with high comfort satisfac- tion, while less adverse drug reactions.