摘要
目的：探讨老年无痛纤维支气管镜检查中应用舒芬太尼复合丙泊酚麻醉的舒芬太尼最佳剂量。方法：将2015年1～12月我院行无痛纤维支气管镜检查的老年患者120例随机均分为A、B、C组,分别应用0.1μg/kg、0.15μg/kg、0.2μg/kg舒芬太尼联合2 mg/kg丙泊酚麻醉。对比3组血氧饱和度（Sp O2）、心率（HR）、平均动脉压（MAP）的变化及不良反应。结果：与诱导前对比,所有患者在诱导后MAP均下降（P〈0.05）;纤维支气管镜入声门时C组MAP低于A、B组（P〈0.05）;镜检中、镜检毕C组MAP低于A组（P〈0.05）。与诱导前对比,所有患者在诱导后HR均下降（P〈0.05）,纤维支气管镜入声门时A、B组HR恢复至诱导前水平,C组仍低于诱导前（P〈0.05）。在纤维支气管镜入声门时,所有患者Sp O2均下降（P〈0.05）。术中肢体活动、心动过速C组少于A、B组,恶心呕吐C、B组少于A组,但呼吸抑制C组高于A、B组,差异均有统计学意义（P〈0.05）。结论：在老年无痛纤维支气管镜检查中,0.15μg/kg舒芬太尼复合丙泊酚麻醉对患者呼吸循环功能影响较轻,患者并发症相对较少。
Objective： To investigate the optimal dosage of sufentanil plus propofol in elderly patients undergoing painless bronchofiberscopy.Methods： One hundred and twenty elderly cases received painless fiberoptic bronchoscopy in our hospital were included from January to December of 2015,and randomized into group A（ sufentanil 0.1 μg / kg＋2 mg / kg propofol）,B（ sufentanil 0.15 μg / kg＋2 mg / kg propofol） and C（ sufentanil 0.2 μg / kg＋2 mg / kg propofol） by the analgesic dose.The three groups were compared regarding the changes of Sp O2,hearth rate（ HR） and mean arterial pressure（ MAP） and adverse reactions during bronchofiberscopy.Results： Compared to the indicators recorded before anesthesia induction,significantly decreased MAP,HR and Sp O2 were observed in all patients（ P〈0.05）.Group C had lower MAP than group A and B as the bronchofiberscope reaching glottis,and lower MAP than group A during and at completion of the bronchoscopy（ P〈0.05）.However,HR was restored to the level recorded before induction in group A and B,and remained lower in group C upon bronchoscope reaching the glottis（ P〈0.05）.Group C had lower rate of physical activity and incidence of tachycardia than group A and B,and group C and B had fewer rate of nausea and vomiting than group A,yet group C had higher incidence of respiratory depression. The difference was significant among the three groups（ P〈0.05）.Conclusion： Sufentanil 0.15 μg / kg＋2 mg / kg propofol is recommended for elderly patients undergoing painless fiberoptic bronchoscopy,for this dose can produce less effect on the respiratory and circulatory function as well as fewer complications associated with anesthesia.
出处
《皖南医学院学报》
CAS
2016年第5期497-499,共3页
Journal of Wannan Medical College
关键词
舒芬太尼
丙泊酚
纤维支气管镜
老年科
呼吸循环功能
sufentanil
propofol
bronchofiberscopy
geriatrics
respiratory and circulatory function
