脑电双频指数监测下右美托咪定在无痛支气管镜检查中的应用

Application of Dexmedetomidine in Painless Bronchoscopy Under EEG Bispectral Index Monitoring

目的:分析无痛支气管镜检查麻醉需求,评价脑电双频指数(bispectral index,BIS)监测下使用右美托咪定的价值。方法:选择本院2019年7月~2020年5月进行无痛支气管镜检查的110例患者,按照入院先后顺序分为对照组、观察组,各55例。BIS监测下,对照组患者术前使用生理盐水、术前5min静推舒芬太尼,观察组患者入室后静脉泵注右美托咪定、术前5min静注舒芬太尼。比较患者手术相关时间、药物使用情况、患者不良反应以及BIS情况。结果:组间麻醉时间、苏醒时间以及出室时间比较,观察组麻醉时间(28.22±6.80)min、苏醒时间(2.75±1.03)min以及出室时间(6.85±2.03)min均明显高于对照组,P<0.05;组间丙泊酚用量比较,观察组用量(156.80±30.50)mg少于对照组,P<0.05;组间呛咳以及低氧血症发生率比较,观察组发生率(12.72%、9.09%)均低于对照组,P<0.05;部分时间点BIS监测下观察组患者镇静参数低于对照组,P<0.05。结论:无痛支气管镜检查中BIS监测下右美托咪定联合用药可以减少患者不良反应发生、减少丙泊酚用量,促进患者预后。

Objective:To analyze the need for anesthesia in painless bronchoscopy and evaluate the value of dexmedetomidine under EEG bispectral index(BIS)monitoring.Methods:We selected 110 patients who underwent painless bronchoscopy in our hospital from July 2019 to May 2020,and performed the control group and the observation group according to the order of admission,with 55 cases in each group.Under BIS monitoring,patients in the control group were given normal saline before surgery and sufentanil was intravenously administered 5 minutes before surgery,while patients in the observation group were given dexmedetomidine intravenously after entering the room,and sufentanil was given intravenously 5 minutes before surgery.Compare patients’operation-related time,drug usage,patient adverse reactions,and BIS status.Results:Comparing the anesthesia time,wake-up time and out-of-room time between the groups,the anesthesia time(28.22±6.80)min,wake-up time(2.75±1.03)min and out-of-room time(6.85±2.03)min of the observation group were significantly higher than those of the control group P<0.05;Comparison of propofol dosage between groups,dosage of observation group(156.80±30.50)mg less than the control group P<0.05;Comparing the incidence of coughing and hypoxemia between the groups,the incidence of observation group(12.72%,9.09%)was lower than that of the control group P<0.05;Some time points in the observation group under BIS monitoring The sedation parameters were lower than those of the control group,P<0.05.Conclusion:The combination of dexmedetomidine under BIS monitoring in painless bronchoscopy can reduce the occurrence of adverse reactions in patients,reduce the dosage of propofol,and promote the prognosis of patients.