丙泊酚、依托咪酯分别联合瑞芬太尼靶控输注在无痛气管镜硬镜检查中的麻醉效果观察
Anesthetic effects of propofol and etomidate separately combined with remifentanil target controlled infusion in painless rigid bronchoscopy
李娜 1杨明媛 1程庆好1
作者信息
摘要
目的:探究丙泊酚、依托咪酯分别联合瑞芬太尼靶控输注(target controlled infusion,TCI)在无痛气管镜硬镜检查中的麻醉效果.方法:将60例行无痛气管镜硬镜检查的患者分为丙泊酚(P)组及依托咪酯(E)组,两组均30例.P组实施丙泊酚联合瑞芬太尼TCI,E组实施依托咪酯联合瑞芬太尼TCI,比较两组入睡时间及苏醒时间,以及麻醉前(T0)、气管镜到达声门即刻(T1)、检查完毕即刻(T2)、检查完毕10 min(T3)的生命体征指标,记录应激状况,并对不良反应发生情况进行分析.结果:两组入睡时间及苏醒时间对比未见显著差异;与T0时刻比,两组T1、T2 时刻平均动脉压(mean arterial pressure,MAP)、血氧饱和度(pulse oxygen saturation,SpO2)、心率(heart rate,HR)均升高,T3时刻上述指标较T2时刻均下降,T1、T3时刻,E组MAP、SpO2、HR均高于P组;E组注射痛、低血压发生率较P组低,两组恶心呕吐以及心动过缓发生率对比无明显差异.结论:无痛气管镜硬镜检查中应用依托咪酯联合瑞芬太尼TCI,表现出了更好的麻醉效果,在维持患者生命体征稳定方面优势明显,且注射痛、低血压发生率更低.
Abstract
Objective To investigate the anesthetic effects of propofol and etomidate separately combined with remifentanil target controlled infusion(TCI)in painless rigid bronchoscopy.Methods A total of 60 patients who underwent painless rigid bron-choscopy were divided into propofol(P)group and etomidate(E)group with 30 patients in each group.P group received propofol combined with remifentanil TCI while E group received etomidate combined with remifentanil TCI.The time to fall asleep,wake-up time,vital signs before anesthesia(T0),immediately after the bronchoscope reaching the glottis(T1),immediately after the end of examination(T2)and at 10 min after the end of examination(T3)were compared between the two groups.Stress status was re-corded,and the occurrence of adverse reactions was analyzed.Results There was no significant difference in the time to fall asleep or wake-up time between the two groups.Compared with T0,there were increases in mean arterial pressure(MAP),pulse oxygen saturation(SpO2)and heart rate(HR)in both groups at T1 and T2,and decreases at T3.From T1 to T3,MAP,SpO2 and HR in E group were higher than those in P group.The incidence rates of injection pain and hypotension in E group were lower than those in P group.The incidence rates of nausea and vomiting and bradycardia in the two groups were close.Conclusion Applying etomidate combined with remifentanil TCI in painless rigid bronchoscopy can achieve better anesthetic effects.It has obvious advantages in maintaining stable vital signs,and the incidence rates of injection pain and hypotension are lower.
关键词
无痛气管镜硬镜检查/丙泊酚/依托咪酯/瑞芬太尼/靶控输注/麻醉效果Key words
painless rigid bronchoscopy/propofol/etomidate/remifentanil/target controlled infusion/anesthetic effect引用本文复制引用
基金项目
北京市科技计划项目(KJ2020CX142)
出版年
2024
NETL
NSTL
万方数据