丙泊酚复合瑞芬太尼靶控输注麻醉在无痛支气管镜检查中的应用

Application of propofol combined with remifentanil target controlled infusion anesthesia in painless bronchoscopy

目的:分析用靶控输注丙泊酚复合瑞芬太尼的方式对接受无痛支气管镜检查的患者进行麻醉的临床效果。方法:选取2018年1月至2019年7月期间在西安交通大学附属胸科医院接受无痛支气管镜检查的70例患者为研究对象。采用随机数表法将其分为对照组和观察组,每组各35例患者。采用静脉推注瑞芬太尼联合丙泊酚的方式对对照组患者进行麻醉,采用靶控输注丙泊酚复合瑞芬太尼的方式对观察组患者进行麻醉。检查结束后,对比两组患者麻醉苏醒的时间、恶心呕吐和疼痛的发生情况,同时比较其麻醉中知晓的发生率。结果:检查结束后,与对照组患者相比,观察组患者拔除喉罩的时间、能完成指令的时间、呼之睁眼的时间、恢复自主呼吸的时间均较短,其恶心呕吐的发生率较低,其中VAS评分大于3分患者的占比较低,P<0.05。与对照组患者相比,观察组患者麻醉中知晓的发生率较低,P<0.05。结论:对接受无痛支气管镜检查的患者采用靶控输注丙泊酚复合瑞芬太尼的方式进行麻醉可缩短其麻醉苏醒的时间,降低其麻醉中知晓的发生率、检查结束后恶心呕吐及疼痛的发生率。

Objective:To analyze the clinical effect of target-controlled infusion of propofol combined with remifentanil on anesthesia in patients undergoing painless bronchoscopy.Methods:A total of 70 patients who underwent painless bronchoscopy in the Chest Hospital of Xi'an Jiaotong University from January 2018 to July 2019 were selected as study subjects.They were divided into control group and observation group by random number table method,35 patients in each group.Patients in the control group were anesthetized by intravenous infusion of remifentanil combined with propofol,and patients in the observation group were anesthetized by targetcontrolled infusion of propofol combined with remifentanil.After the examination,the time of anesthesia awakening,the incidence of nausea,vomiting,and pain were compared between the two groups,and the incidence of anesthesia awareness was compared.Results:After the examination,compared with the control group,patients in the observation group had shorter time to remove the laryngeal mask airway,shorter time to complete instructions,shorter time to open their eyes and shorter time to regain spontaneous breathing.The incidence of nausea and vomiting was relatively low,and the proportion of patients with VAS score greater than 3 points was relatively low(P<0.05).Compared with the control group,the incidence of anesthesia awareness was lower in the observation group(P<0.05).Conclusion:Target-controlled infusion of propofol combined with remifentanil can shorten the time of anesthesia recovery,reduce the incidence of anesthesia awareness,nausea,vomiting,and pain after examination in patients undergoing painless bronchoscopy.