摘要
目的：比较单纯吸入七氟醚与靶控输注异丙酚复合瑞芬太尼用于喉罩辅助支气管镜检查的效果。方法选择ASAⅠ~Ⅱ级择期全麻下行纤支镜检查患者80例，应用随机数字表法分成七氟醚组（S组）和靶控输注异丙酚复合瑞芬太尼组（PR组），每组40例。S组：潮气量法七氟醚吸入诱导，意识消失后置入喉罩，七氟醚呼气末肺泡浓度达到3.5%15 min后开始检查。PR组：靶控输注异丙酚，血浆浓度为3μg/ml，靶控输注瑞芬太尼，血浆浓度为5 ng/ml，意识消失后置入喉罩，两药血浆-效应室浓度达到平衡5 min后开始检查。两组行机械通气，新鲜气流量1.5 L/min，PETCO235~45 mmHg。记录心血管事件发生情况、血管活性药物使用情况、术中呛咳发生情况、苏醒后躁动、术后24 h内恶心呕吐发生情况、检查时间和苏醒时间。结果与S组比较，PR组心血管事件发生率、血管活性药物使用率、术中呛咳发生率增高，差异有统计学意义（P〈0.05）；两组支气管痉挛发生率、检查时间、苏醒时间、苏醒后躁动、术后恶心呕吐发生率差异无统计学意义（P〉0.05）。结论与靶控输注异丙酚复合瑞芬太尼相比，单纯吸入七氟醚更适用于喉罩辅助支气管镜检查，有利于改善麻醉质量。
Objective To compare the effect of inhalational anesthesia with sevoflurane versus target-con-trolled infusion anesthesia with propofol and remifentanil in patients undergoing laryngeal mask auxiliary fibronchos-copy examination. Methods Eighty ASAⅠ~Ⅱpatients who were scheduled for fibronchoscopy examination were randomly divided into 2 groups （n=40）. Patients in one group were treated with sevoflurane（group S） and patients in-the other group were treated with propofol-remifentanil （group PR）. In group S, the fiberbronchoscopy examination was inducted by tidal volume method. A laryngeal mask was placed when the patient＇s consciousness disappeared. The concentration of sevoflurane in pulmonary alveolus was 3.5%at the end of expiration and the examination started 15 minutes later. In group PR, anesthesia was induced by propofol and remifentanil and both of them were given by TCI . The target effect site concentration of propofol was 3μg/ml and that of remifentanil was 5.0ng/ml. A laryngeal mask was placed when the patient＇s consciousness disappeared. The examination started 5 minutes after the plasma-chamber concentration of both medication was balanced. Patients in both group underwent mechanical ventilation and the fresh air flow was 1.5 L/min and the PETCO2 was 35~45 mmHg. The occurrence of cardiovascular event was recorded, as well as the usage of vasoactive drugs, the occurrence of bucking during the operation, the agitation after revival, the occurrence of nausea and vomiting 24 hours after the operation, the duration of operation and the awakening time. Results Compared with group S, patients in group PR showed significantly higher incidence of cardiovascular events, vasoactive drugs usage and bucking during the operation and significantly prolongated time of fibronchoscopy examination. However, there were no differences in the incidence of bronchiospasm, awakening time, agitation after revival and nausea and vomiting after the operation between two groups. Conclusion Compared with intravnenous anesthesia with propofol-remifentanil, inhalational anesthesia with sevoflurane is more suitable for fibronchoscopy ex-amination and could improve the quality of anesthesia.
出处
《海南医学》
CAS
2014年第14期2063-2065,共3页
Hainan Medical Journal
基金
广东省中山市医学科研基金项目(编号:2013A020324)
关键词
七氟醚
二异丙酚
瑞芬太尼
喉罩
支气管镜检术
Sevoflurane
Propofol
Remifentanil
Laryngeal mask
Fibronchoscopy examination
