摘要
目的比较喉罩通气静脉全身麻醉和内镜面罩通气清醒镇静在纤维支气管镜检查中的临床应用效果。方法选取美国麻醉医师协会（ASA）分级Ⅰ-Ⅱ级、年龄18-70岁、拟行纤维支气管镜检查患者80例,将其分为喉罩组（A组）40例和内镜面罩组（B组）40例。A组患者静脉给予舒芬太尼（0.2μg/kg）、丙泊酚（1.5-2.0 mg/kg）、罗库溴铵（0.3 mg/kg）,置入喉罩,控制通气,连接T型接头进行检查。B组患者静脉给予舒芬太尼（0.2μg/kg）、咪达唑仑（0.02 mg/kg）、丙泊酚（0.5-1.0 mg/kg）使患者达到Ramsey 2-4分,内镜面罩辅助通气,并通过面罩检查孔经鼻腔进行检查。观察记录两组患者麻醉前（T1）、检查中（T2）、检查后（T3）各时点平均动脉压（MAP）、心率（HR）、脉搏血氧饱和度（Sp O2）,记录两组患者检查时间和复苏时间、麻醉效果及术后随访的满意度。结果 A组患者在T2时MAP低于B组,差异有统计学意义（P〈0.05）,而两组患者其他时点MAP、HR、Sp O2比较,差异均无统计学意义（P〉0.05）。两组患者检查时间比较,差异无统计学意义（P〉0.05）,A组患者复苏时间明显长于B组,差异有统计学意义（P〈0.05）;两组患者术中麻醉效果及术后满意度比较,差异均无统计学意义（P〉0.05）。结论在纤维支气管镜检查中使用内镜面罩通气清醒镇静安全有效,与喉罩静脉全身麻醉比较具有对循环影响小、患者复苏快且不降低麻醉效果和患者满意度的优点。
Objective To compare the clinical application effects of laryngeal mask ventilation venous general anesthe-sia and endoscopic facial mask conscious sedation in fiberobronchoscopy examination. Methods Eighty patients undergoing fiberobronchoscopy examination,ASAⅠ-Ⅱgrade and aged 18-70 years old,were divided into the laryngeal mask group（A,40 cases）and endoscopic facial mask group（B,40 cases）. The group A was intravenously given sufentanil 0.2 μg/kg,propofol 1.5-2.0 mg/kg and rocuronium bromide 0.3 mg/kg,placing the laryngeal mask for controlling ventilation and connecting T-type adapter for conducting the examination. The group B was intravenously given sufentanil 0.2 μg/kg,midazolam 0.02 mg/kg and propofol 0.5-1.0mg/kg for reaching the Ramsey score 2-4,endoscopic facial mask assisted ventilation and conducted the examination via nasal cavity by passing facial mask examination hole. The values of mean arterial pressure（MAP）,heart rate（HR）,pulse oxygen saturation（Sp O2） at different time points of before anesthesia（T1）,during examination（T2） and after examination（T3） were observed and recorded in each group. The examination time,recovery time,anesthesia effect and postoperative follow up satisfaction were recorded in the two groups. Results MAP at T2 in the group A was lower than that in the group B with statistical difference（P〈0.05）,while MAP,HR and Sp O2 at other time points had no statistically significant difference between the two groups（P〈0.05）.The examination time had no statistically significant difference between the two groups（P〈0.05）. The recovery time in the group A was significantly longer than that the group B with statistical difference（P〈0.05）;while the intraoperative anesthesia effect and postoperative satisfaction had no statistical differences between the two groups（P〈0.05）. Conclusion Using endoscopic facial mask conscious sedation in fiberobronchoscopy examination is safe and effective compared with the laryngeal mask venous general anesthesia,which has the advantages of small influence on circulation and rapid recovery without reducing anesthesia effect and patients satisfaction.
出处
《现代医药卫生》
2016年第4期524-526,共3页
Journal of Modern Medicine & Health
关键词
麻醉
全身
输注
静脉内
喉面罩
内镜面罩
清醒镇静
支气管镜检查
Anesthesia
general
Infusions
intravenous
Laryngeal masks
Endoscopic mask
Conscious sedation
Bronchoscopy
