摘要
目的比较不同剂量右美托咪定联合七氟烷对纤维支气管镜检查术患者的麻醉效果。方法将100例行纤维支气管镜检查的患者随机分为七氟烷组(A组)、0.25μg/kg右美托咪定联合七氟烷组(B组)、0.50μg/kg右美托咪定联合七氟烷组(C组)、0.75μg/kg右美托咪定联合七氟烷组(D组)、1.00μg/kg右美托咪定联合七氟烷组(E组)5组,每组20例,记录患者入手术室后(T1)、脑电双频谱指数(BIS)<60时(T2)、喉罩置入后(T3)、纤维支气管镜到达支气管时(T4)各时点患者血氧饱和度(SpO2)、心率(HR)、平均动脉压(MAP),记录术中及术后患者呛咳、体动、支气管痉挛、缺氧情况,同时记录患者到达BIS<60和苏醒时间。结果分组对患者HR、MAP有明显影响(F组间=5.78、7.46,P<0.05),且在T2时E组HR、MAP低于A组(F=9.73、11.25,P<0.05),T3、T4时C、D、E组HR、MAP低于A组(F=5.38~16.72,P<0.05),其中C、D组患者在纤维支气管镜检查过程中HR、MAP较为稳定。时间和分组对患者SpO2没有明显影响(P>0.05)。C、D、E组到达BIS<60的时间快于A组(F=5.20,q=3.36~4.59,P<0.05);C、D组苏醒时间与A组相比无明显差异,E组苏醒时间较A组延长(F=2.68,q=4.12,P<0.05);C、D组不良反应情况明显轻于A组(χ^2=4.33、4.33,P<0.05)。结论0.50μg/kg和0.75μg/kg右美托咪定联合七氟烷用于纤维支气管镜检查对患者生命体征影响小、诱导及苏醒快、不良反应少。
Objective\To investigate the anesthetic effects of different doses of dexmedetomidine combined with sevoflurane in patients undergoing fiberoptic bronchoscopy.\Methods\A total of 100 patients undergoing fiberoptic bronchoscopy were randomly and equally divided into group A(sevoflurane),group B(0.25μg/kg dexmedetomidine combined with sevoflurane),group C(0.50μg/kg dexmedetomidine combined with sevoflurane),group D(0.75μg/kg dexmedetomidine combined with sevoflurane),and group E(1.00μg/kg dexmedetomidine combined with sevoflurane).Pulse oxygen saturation(SpO2),heart rate(HR),and mean arterial pressure(MAP)were recorded after the patients entered the operating room(T1),when bispectral index(BIS)was<60(T2),after the laryngeal mask was inserted(T3),and when the fiberoptic bronchoscope reached the bronchus(T4),and intraoperative and postoperative bucking,body motion,bronchospasm,and anoxia,as well as time to BIS<60 and awakening time,were recorded.\Results\Grouping had a significant effect on HR and MAP(Fintergroup=5.78,7.46,P<0.05);group E had significantly lower HR and MAP than group A at T2(F=9.73,11.25,P<0.05),and groups C,D,and E had significantly lower HR and MAP than group A at T3 and T4(F=5.38-16.72,P<0.05);groups C and D showed stable HR and MAP during fiberoptic bronchoscopy.Timing and grouping had no significant effect on SpO2(P>0.05).Groups C,D,and E had a significantly shorter time to BIS<60 than group A(F=5.20,q=3.36-4.59,P<0.05).There was no significant difference in awa-kening time between group C or D and group A,while group E had a significantly prolonged awakening time compared with group A(F=2.68,q=4.12,P<0.05).The incidence of adverse reactions in groups C and D were significantly lower than that in group A(χ^2=4.33,4.33,P<0.05).\Conclusion\0.50μg/kg and 0.75μg/kg dexmedetomidine combined with sevoflurane for fiberoptic bronchoscopy has little impact on the vital signs of patients,provides rapid induction and awakening,and causes fewer adverse reactions.
作者
粟鸿林
陆敏
骆喜宝
SU Honglin;LU Min;LUO Xibao(Department of Anesthesiology,The Second Affiliated Hospital of Guilin Medical University, Guilin 541199, China)
出处
《精准医学杂志》
2020年第6期477-480,共4页
Journal of Precision Medicine
基金
广西壮族自治区卫生和计划生育委员会自筹经费项目(Z20180108)。
关键词
右美托咪啶
七氟烷
支气管镜检查
心率
动脉压
麻醉效果
Dexmedetomidine
Sevoflurane
Bronchoscopy
Heart rate
Arterial pressure
Anesthetic effect
作者简介
通讯作者:粟鸿林,Email:260020461@qq.com。
