超声引导下喉上神经阻滞联合右美托咪定泵注在老年患者纤支镜检查术中的应用

Application of ultrasound-guided superior laryngeal nerve block combined with dexmedetomidine pumping in elderly patients undergoing fiberoptic bronchoscope

目的探究超声引导下喉上神经阻滞联合右美托咪定泵注在老年患者纤维支气管镜(纤支镜)检查术中的应用价值。方法90例行纤支镜检查的老年患者,依据检查麻醉方式不同分为试验组(46例)与对照组(44例)。两组均采用右美托咪定泵注,试验组采用超声引导下喉上神经阻滞进行麻醉,对照组采用喷洒局部麻醉(局麻)药进行麻醉。对比两组各时段[入手术室后(T_(0))、开始检查前(T_(1))、声门进入纤支镜时(T_(2))、纤支镜达到隆突(T_(3))、完成检查(T_(4))、完成检查后10 min(T_(5))]生命体征及不良反应发生情况。结果T_(2)、T_(3)、T_(4)时,试验组清醒镇静评分(OAA/S)、心率(HR)、平均动脉压(MAP)均低于对照组,差异有统计学意义(P<0.05)。试验组咽喉痛发生率2.17%低于对照组的18.18%,差异有统计学意义(P<0.05)。结论对实行纤支镜检查术的老年患者泵注右美托咪定联合超声引导下喉上神经阻滞价值较高,建议推广。

Objective To investigate the application value of ultrasound-guided superior laryngeal nerve block combined with dexmedetomidine pumping in elderly patients undergoing fiberoptic bronchoscope.Methods A total of A total of 90 elderly patients undergoing fiberoptic bronchoscope were divided into the experimental group(46 cases)and the control group(44 cases)according to different anesthesia methods.Both groups received dexmedetomidine pumping,on this basis,the experimental group was anesthetized by superior laryngeal nerve block(ultrasound-guided),and the control group was anesthetized by local anesthetic spraying.The vital signs at different time points[after entering the operating room(T_(0)),before starting the examination(T_(1)),when the glottis entered the bronchoscope(T_(2)),when the bronchoscope reached the carina(T_(3)),when the examination was completed(T_(4)),and 10 min after completing the examination(T_(5))],and occurrence of adverse reactions were compared between the two groups.Results At T_(2),T_(3),and T_(4),the observer's assessment of alertness/sedation(OAA/S)score,heart rate(HR),and mean arterial pressure(MAP)in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of sore throat 2.17% in the experimental group was lower than 18.18% in the control group,and the difference was statistically significant(P<0.05).Conclusion For elderly patients undergoing fiberoptic bronchoscope,dexmedetomidine pumping combined with ultrasound guided superior laryngeal nerve block is of high value,and it is recommended for promotion.