摘要
目的 评价支气管内超声引导针吸活检术患者复合咪达唑仑-吗啡时TCI不同浓度异丙酚麻醉的效果.方法 择期行支气管内超声引导针吸活检术患者40例,ASA分级Ⅰ或Ⅱ级,随机分为2组（n=20）,P1组和P2组静脉注射咪达唑仑0.03 mg/kg和吗啡0.05 mg/kg,于咽喉部行表面麻醉,TCI异丙酚,P1组和P2组血浆靶浓度分别为3、4 μg/ml.输注异丙酚5 min时开始手术.手术开始后30 min采集动脉血样,进行动脉血气分析;手术结束时记录PETCO2.记录连续呛咳次数、体动、利多卡因用量、定向力恢复时间、患者对麻醉满意度、术中及术后不良反应的发生情况.结果 与P1组比较,P2组pH值和PaO2降低,PaCO2和PETCO2升高（P＜0.05）,连续呛咳次数、体动、利多卡因用量、定向力恢复时间、患者对麻醉满意度及不良反应发生率差异无统计学意义（P＞0.05）.结论复合咪达唑仑0.03 mg/kg和吗啡0.05 mg/kg时支气管内超声引导针吸活检术患者TCI异丙酚（血浆靶浓度3μg/ml）的麻醉效果好,术后恢复快,安全性良好.
Objective To evaluate the effectiveness of midazolam and morphine combined with TCI of propofol for endobronchial ultrasound-guided transbronchial needle aspiration （ EBUS-TBNA ）. Methods Forty ASA Ⅰ or Ⅱ patients undergoing elective EBUS-TBNA were randomly divided into 2 groups according to the plasma concentration （Cp） of TCI of propofol （n=20 each）： group Ⅰ Cp = 3 μg/ml （group P1） and group Ⅱ Cp = 4 μg/ml （group P2 ）. Midazolam 0.03 mg/kg and morphine 0.05 mg/kg were administered iv followed by topical anesthesia of laryngopharynx with 4% hdocaine. TCI of propofol was started at 5 min before surgery. The patients kept spontaneous breathing during operation. MAP, HR and SpO2 were continuously monitored and recorded before anesthesia （baseline） and at 30 min after beginning of surgery and emergence from anesthesia. Arterial blood gas analysis was performed at 30 min after beginning of surgery and PETCO2 was measured at the end of surgery. The amount of 4% lidocaine used for topical anesthesia, the adverse reactions and the level of patient＇s satisfaction were recorded. Results PaO2 and pH value were significantly lower while PaCO2 and PET CO2 higher in group P2 than in group P1. There was no significant difference in the emergence time, the amount of 4% lidocaine used,the adverse reactions and the level of patient＇s satisfaction between the 2 groups. Conclusion TCI of propofol at Cp of 3 μg/ml can provide satisfactory anesthesia for EBUS-TBNA with less respiratory depression and more rapid emergence than that at Cp of 4 μg/ml.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2010年第10期1227-1229,共3页
Chinese Journal of Anesthesiology
