两种麻醉方法应用于支气管镜操作中的比较研究

Comparative study of two kinds of anesthesia methods used in bronchoscopy

目的观察比较利多卡因雾化吸入表面麻醉联合小剂量咪唑安定静脉注射与异丙酚静脉麻醉两种麻醉方法在支气管镜操作中的优缺点。方法将120例入选病人随机分为表麻组及静脉麻醉组,观察记录两组患者呼吸抑制、呛咳、体动、检查中断情况以及检查前中后心率、呼吸、血氧饱和度、收缩压、舒张压的变化和术后问卷调查的差异。结果表麻组对心率、呼吸、血氧饱和度、收缩压、舒张压影响小,对整个操作无影响,静脉麻组对心率、呼吸、血氧饱和度、收缩压、舒张压影响大,但舒适性较高。结论在支气管镜操作中小剂量咪唑安定联合利多卡因表面麻醉效果与异丙酚静脉麻醉效果相当,但前者安全性更好,费用更低。

Objective To observe and compare the advantages and disadvantages of the two methods of anesthesia in the operation of bronchoscopy between the inhalation of lidocaine topical anesthesia combined with small dose of midazolam intravenous injection and the propofol intravenous anesthesia method. Methods 120 patients selected patients were randomly divided into table linen and painless group, observed two groups of patients with respiratory inhibition, choking cough, body move, checked the disruptions before and after the heart rate, breathing, blood oxygen saturation, the change of the systolic pressure, diastolic blood pressure, the differences between the postoperative questionnaires. Results In table linen group, effects on heart rate, respiration, blood oxygen saturation, systolic pressure, diastolic blood pressure were small, no effect to the whole operation;in the vein hemp group, effects on heart rate, respiration, blood oxygen saturation, systolic pressure, diastolic pressure were big, but comfort was higher. Conclusions In bronchoscopy operation, effect between small dose of midazolam combined with lidocaine topical anesthesia and propofol intravenous anesthesia is equivalent, but the former is better in security and lower in cost.