摘要
目的:探讨不同剂量芬太尼联合丙泊酚在无痛纤支镜检查中的应用效果。方法:选取2021年6月至2023年11月期间于本院门诊行无痛纤支镜检查的患者144例作为研究对象。按随机数字表法将患者分为A组、B组和C组,每组各48例。三组分别采用不同剂量芬太尼联合丙泊酚进行麻醉。A、B、C组芬太尼应用剂量分别为2μg·kg^(-1)、3μg·kg^(-1)、4μg·kg^(-1)。分析比较三组的麻醉效果、血流动力学指标(诱导前(T0)、诱导后5min(T1)、喉罩置入时(T2)、入镜后5min(T3)、拔管时(T4)的心率(Heart rate,HR)和平均动脉压(Mean arterial pressure,MAP))以及不良反应。结果:B、C组麻醉效果均显著优于A组(P<0.05),但B、C组的麻醉效果无显著差异(P>0.05)。三组的T0、T1、T4时点HR和MAP比较均无显著差异(P>0.05);B、C两组T2、T3时点的HR和MAP均显著低于A组(P<0.05),但B、C组间无显著差异(P>0.05)。B组的不良反应发生率较A、C组均显著降低(P<0.05),A、C两组不良反应发生率无显著差异(P>0.05)。结论:3μg·kg^(-1)芬太尼联合丙泊酚用于无痛纤支镜检查,较其他剂量可获得相对理想的麻醉效果,更利于维持患者血流动力学稳定,且安全性好。
Objective:To investigate the effect of different doses of fentanyl combined with propofol in painless bronchoscopy.Methods:144 patients who underwent painless bronchoscopy in the outpatient department of our hospital from June 2021 to November 2023 were selected as the study objects.The patients were divided into group A,group B and group C by random number table method,with 48 cases in each group.Three groups were anesthetized with different doses of fentanyl combined with propofol.The applied doses of fentanyl in groups A,B and C were 2μg·kg^(-1),3μg·kg^(-1) and 4μg·kg^(-1),respectively.Anesthesia effect,hemodynamic indexes(Heart rate(HR)and mean arterial pressure(MAP)before induction(T0),5 minutes after induction(T1),laryngeal mask placement(T2),5 minutes after implantation(T3),and extubation(T4))and adverse reactions of the three groups were analyzed and compared.Results:The anesthetic effect of groups B and C was significantly better than that of group A(P<0.05),but there was no significant difference between groups B and C(P>0.05).There were no significant differences in HR and MAP at T0,T1 and T4 among the three groups(P>0.05).HR and MAP of T2 and T3 time points in groups B and C were significantly lower than those in group A(P<0.05),but there was no significant difference between groups B and C(P>0.05).The incidence of adverse reactions in group B was significantly lower than that in groups A and C(P<0.05),but there was no significant difference between groups A and C(P>0.05).Conclusion:3μg·kg^(-1) fentanyl combined with propofol for painless fiberoptic bronchoscopy can obtain relatively ideal anesthetic effect compared with other doses,and is more conducive to maintaining hemodynamic stability in patients with good safety.
作者
郭国祥
Guo Guo-xiang(Department of Anesthesiology,Biyang People's Hospital,Zhumadian 463700,Henan,China)
关键词
纤支镜
无痛检查
丙泊酚
芬太尼
血流动力学
Bronchoscopy
Painless examination
Propofol
Fentanyl
Hemodynamics
