舒芬太尼和瑞芬太尼在喉罩全身麻醉无痛纤维支气管镜检查中的应用

The application comparison of Sufentanil and Remifentanil in painless flexible bronchoscopy with laryngeal mask airway

目的 探讨舒芬太尼和瑞芬太尼在喉罩全身麻醉无痛纤维支气管镜检查中的应用。方法 选择2016年3~5月我院18~70岁,ASA I~Ⅲ级行无痛纤支镜检查的患者80例,随机分为舒芬太尼组（S组）和瑞芬太尼组（R组）,比较两组检查过程中及检查结束后恢复室内不良事件的发生情况、苏醒时间及患者医生的满意度。结果 检查过程中两组患者呛咳、体动、喉痉挛、喉罩对位不良、高血压、心动过速的发生率比较,差异无统计学意义（P〉0.05）,R组低血压、心动过缓发生率显著高于S组（P〈0.05）,R组苏醒时间显著短于S组（P〈0.05）;恢复室内R组高血压、心动过速、发生率显著高于S组（P〈0.05）,R组SAS评分显著高于S组（P〈0.05）,T1,T2,T3各时间点R组MAP低于S组,T1、T3HR低于S组（（P〈0.05））。结论 舒芬太尼和瑞芬太尼均可用于喉罩全身麻醉无痛纤维支气管镜检查,舒芬太尼组较瑞芬太尼组血流动力学更为平稳,检查期间及恢复室内不良事件更少,但苏醒时间更慢。

Objective To explore Sufentanil and Remifentanil in painless flexible bronchoscopy with laryngeal mask airway.Methods 80 ASA Ⅰ-Ⅲpatients aged 18-70 from March to May 2016 in our tospieal who were scheduled to undergo painless flexible bronchoscopy were randomly divided into Sufentanil group（group S） and Remifentanil group（ group R）.The adverse events during and after the procedure,the awake time and the satisfaction of the doctor and patients were compared between two groups.Results During the procedure,there were no significant difference in the cough,body motiob,laryngospasm,dislocation of the LMA,hypertension,tachycardia between the two groups （P〉0.05）,the incidence rates of hypotension and bradycardia in group R were higher than thoes of group S （P〈0.05）,the awake time in group R was shorter than that of group S （P〈0.05）,and during the recovery room,the incidence rates of hypertension and tachycardia in group R were higher than that of group S,the SAS score of group R was higher than that of group S （P〈0.05）,MAP of group R was.lower than that of group at T1,T2,T3,HR of T1,T3 was lower than that of group S （P〈0.05）.Conclusion Sufentanil and Remifentanil can be used in painless flexible bronchoscopy with laryngeal mask airway,comparing to group R,Sufentanil group has more stable haemodynamics and less adverse events during and after Procedure, but the awake time is longer.