丙泊酚复合瑞芬太尼靶控输注用于纤维支气管镜检查的麻醉分析

Anesthesia Analysis of Propofol Combined with Remifentanil Target-controlled In⁃fusion for Fiberoptic Bronchoscopy

目的探讨对纤维支气管镜检查患者采用丙泊酚复合瑞芬太尼完成靶控输注麻醉后获得临床效果。方法选取2018年1月—2020年12月泰安市中医二院收治的78例纤维支气管镜检查患者进行麻醉研究,随机分为常规组(采用丙泊酚复合瑞芬太尼静脉推注方式完成临床麻醉)和研究组(采用丙泊酚复合瑞芬太尼靶控输注方式完成临床麻醉),各39例。比较两组患者麻醉结果。结果研究组呼之睁眼时间(7.22±2.05)min、自主呼吸恢复时间(3.77±1.49)min、拔除喉罩时间(9.79±2.65)min、完成指令时间(8.15±2.05)min均短于常规组,差异有统计学意义(t=4.837、5.798、6.441、4.176,P<0.05);麻醉前,研究组DBP(73.13±10.29)mmHg、SBP(140.49±18.09)mmHg及HR水平(80.55±9.29)次/min同常规组比较,差异无统计学意义(P>0.05);诱导后,研究组DBP(60.25±8.49)mmHg、SBP(115.36±7.96)mmHg及HR水平(91.35±11.55)次/min均低于常规组,差异有统计学意义(P<0.05);术后10 min,研究组DBP(83.03±10.36)mmHg、SBP(130.73±10.13)mmHg及HR水平(76.35±9.33)次/min均低于常规组,差异有统计学意义(P<0.05);研究组术后VAS评分>3分、术中知晓及恶心呕吐发生率均低于常规组,差异有统计学意义(P<0.05)。结论有效应用丙泊酚复合瑞芬太尼靶控输注方式后,有效缩短麻醉苏醒时间,显著改善生命体征、术后随访结果。

Objective To investigate the clinical effect of target-controlled infusion anesthesia with propofol combined with remifentanil in pa⁃tients undergoing fiberoptic bronchoscopy.Methods A total of 78 patients undergoing fiberoptic bronchoscopy who were admitted to Second Hospital of Traditional Chinese Medicine from January 2018 to December 2020 were selected for anesthesia research.They were randomly divided into routine group(with propofol combined with remifentanil intravenous bolus to complete clinical anesthesia)and study group(with propofol combined with remifentanil target-controlled infusion to complete clinical anesthesia),with 39 cases in each group.The anesthesia results of the two groups of patients were compared.Results The time of eye opening when exhaling in the research group was(7.22±2.05)min,the recovery time of spontaneous breathing(3.77±1.49)min,the time to remove the laryngeal mask(9.79±2.65)min,and the time to com⁃plete the command(8.15±2.05)min were all shorter than those of the routine group,the difference was statistically significant(t=4.837,5.798,6.441,4.176,P<0.05).Before anesthesia,the DBP(73.13±10.29)mmHg,SBP(140.49±18.09)mmHg and HR levels(80.55±9.29)times/min of the study group were not significantly different from those of the routine group(P>0.05).After induction,DBP(60.25±8.49)mmHg,SBP(115.36±7.96)mmHg and HR levels(91.35±11.55)times/min in the study group were lower than those in the routine group,the difference was statistically significant(P<0.05).10 min after operation,DBP(83.03±10.36)mmHg,SBP(130.73±10.13)mmHg and HR(76.35±9.33)times/min in the study group were lower than those in the routine group,the difference was statistically significant(P<0.05).The postoperative VAS score>3 points,intraoperative awareness and the incidence of nausea and vomiting in the study group were lower than those in the routine group,the difference was statistically significant(P<0.05).Conclusion The effective application of propofol combined with remifentanil target-controlled infusion can effectively shorten the recovery time from anesthesia.The vital signs and postoperative follow-up results were significantly improved.