无肌松喉罩静脉麻醉在支气管镜检查中的应用

Laryngeal mask combined with total intravenous anesthesia without muscle relaxant applied in fiberoptic bronchoscopy

目的评价不应用肌松药的喉罩静脉麻醉用于患者支气管镜检查的可行性和安全性。方法行支气管镜检查患者60例,随机均分为无肌松喉罩静脉麻醉组(Ⅰ组)和使用肌松药麻醉组(Ⅱ组)。记录检查及喉罩操作过程中的生命体征,记录麻醉效果评级、检查中不良反应及患者满意度等。结果与镜检前比较,Ⅰ组各时点患者收缩压(SBP)、舒张压(DBP)、心率(HR)明显下降,脉搏血氧饱和度(Sp O2)明显升高(P<0.05),Ⅱ组拔除喉罩时患者SBP、DBP与镜检前比较无差异(P>0.05),HR明显增快、Sp O2明显升高(P<0.05)。I组患者在拔除喉罩时SBP、DBP、HR较Ⅱ组低(P<0.05)。两组不良反应发生率及患者满意度差异无统计学意义。结论无肌松喉罩静脉麻醉用于患者支气管镜检查安全可行,是一项值得推广的技术。

Objective To evaluate the clinical effect and safety of laryngeal mask combined with total intravenous anesthesia without muscle relaxant applied in fiberoptic bronchoscopy.Methods 60 patients who scheduled for fiberoptic bronehoscopy were randomly divided into observation group(Group I,n=30)and control group(Group II,n=30).For the observation group,laryngeal mask combined intravenous anesthesia without muscle relaxant was used,while the control group received muscle relaxant.The blood pressure,heart rate and blood oxygen saturation in the two groups of different time points were recorded,and incidence of adverse reactions,patient satisfaction,anesthetic effectiveness and recovery time in the two groups were also compared.Results The HR and BP decreased and SpO2 elevated significantly at each observation time point after anesthesia compared with those before anesthesia in group I(P<0.05).There was no difference in BP in group II when removal of the laryngeal mask airway compared with those before anesthesia(P>0.05),but HR and SpO2 increased significantly(P<0.05).At the point of removal of the laryngeal mask airway,BP and HR were lower in group I than those in group II(P<0.05).There were no more adverse reactions in group I than that in group II(P<0.05).Conclusion It is a safe and effective alternative to painless fiberoptic bronchoscopy of laryngeal mask combined with total intravenous anesthesia without muscle relaxant and it is worthy of clinical promotion.