瑞芬太尼与丙泊酚双通道靶控输注在纤维支气管镜中的应用

目的]探讨瑞芬太尼与丙泊酚双通道靶控输注（TCI）用于无痛纤维支气管镜检查中的合理配伍.方法]选择40例次需行纤支镜（经口）检查的患者,ASAⅠ～Ⅱ级,随机分为四组.分别输注瑞芬太尼0.2 ng/mL、0.4 ng/mL、0.6 ng/mL、0.8 ng/mL,待瑞芬太尼达稳定血药浓度后,靶控输注丙泊酚3.0 μg/mL.观察进镜不同时期的平均动脉压（MAP）、心率（HR）、脉搏血氧饱和度（SpO2）、脑电双频指数（BIS）值以及诱导时间、唤醒时间和定向力恢复时间,记录呼吸抑制、体动、呛咳等不良反应发生的情况.结果]与其他三组相比,输注瑞芬太尼0.6 ng/mL组的各项观测指标优于其他三组.结论]使用3.0 μg/mL丙泊酚复合0.6 ng/mL瑞芬太尼为纤支镜检查的一种安全有效的配伍方案.

Dual-channel Target-controlled Infusion of Remifentanil and Propofol in Fiberbronchoscopy

Objective]To explore the reasonable compatibility of remifentanil and propofol during dual-channel target-controlled infusion for fiberbronchoscopy. Methods] Forty patients with ASAⅠ-Ⅱ who underwent fiberbronchoscopy were randomly divided into 4 groups. Each patient was infused with remifentanil at 0. 2ng/mL, 0.4ng/mL, 0.6ng/mL and 0.8ng/mL, respectively. When blood concentration of remifentanil was up to the steady state 3.0ug/ ml propofol was infused. The mean arterial pressure （MAP）, heart rate （HR）, pulse oxygen（SpO2 ）, bispectral index（B/S）, induction time, wake-up time and orientation recovery time were observed. The adverse reactions such as respiratory depression, body movement , cholking and cough were recorded. Results]The best. outcome was observed with remifentanil infusion at 0. 6ng/mL. Conclusion] The use of 3. 0μg/ml propofol combined with 0. 6ng/ml remifentanil is safe and effective for fiberbronchoscopy,