咪达唑仑清醒镇静在支气管镜检查中的作用及其对肺功能的影响

目的 探讨在支气管镜检查中应用静脉注射咪达唑仑清醒镇静的作用及其对肺功能的影响.方法 40例患者分为A、B两组,各20例,分别采用丁卡因、利多卡因局部麻醉和局部麻醉加咪达唑仑静脉注射镇静;对比患者术中麻醉效果,观察其各时点的生命体征和肺功能指标.结果B组在麻醉效果四个方面均优于A组;两组肺功能指标FVC、FEV1.0及PEF在术后10 min均比术前下降,其中B组FVC下降程度较A组更显著(P<0.05);两组术后4h的肺功能可回到基线水平;A组生命体征指标在术中及术后均较麻醉前有明显波动;B组内仅术中HR、MAP较麻醉前有差异,且A组进声门时HR的升高程度大于B组.结论 静脉应用咪达唑仑清醒镇静安全、有效、便捷,对患者术后4 h肺功能没有影响.

The Effects of conscious sedation via Midazolam during Bronchoscopy and Its Affect on Pulmonary Function

Objective To evaluate the effects and influences of pulmonary function of conscious sedation by midazolam in bronchoscopy.Methods Group A,total of 20 cases,undergoes local anesthesia with tetracaine and lidocaine;group B,20 cases who undergoes local anesthesia combined with midazolam sedation.Compare patients’anesthetic effects,and studied the variation of vital signs and variation of pulmonary function at different points in time.Results Anesthetic effect of two groups were significantly different,group B was better than group A(P<0.05).FVC,FEV1.0 and PEF of two groups at 10 min after examination are all decreased comparing to before examination.The change in the quantity of FVC in group A is less than group B(P<0.05).At the time of 4 h after examination,pulmonary function index recovered.In group A,HR,RR,SaO2 and MAP after examination fluctuated more obviously than before anesthesia(P<0.05);but in group B only HR,MAP increased.Conclusion Midazolam conscious sedation is safe,effective and convenient.4 h after surgery,Midazolam will not lead to significant additional adverse effects on the pulmonary function.