瑞芬太尼在中老年患者无痛支气管镜检查中的临床作用

目的 探讨瑞芬太尼在中老年患者无痛支气管镜检查中的作用.方法 将120例行无痛支气管镜检查的中老年患者随机分为4组(n=30),A组用丙泊酚麻醉,B、C、D组用瑞芬太尼复合丙泊酚麻醉(瑞芬太尼输注剂量:B组0.05μg·kg-1·min-1,C组0.10 μg·kg-1·min-1,D组0.15 μg·kg-1·min-1).观察各组患者在检查过程中的体动反应、血流动力学变化、丙泊酚用量、检查时间、苏醒时间、离室时间及不良反应.结果 在检查过程中,A组的术中体动和呛咳明显高于其他3组(P＜0.05);在血流动力学上,A组波动较大,B、C、D组相对较平稳,但D组低血压、心动过缓、一过性呼吸抑制发生率均较其他3组高(P＜0.05);丙泊酚用量A组明显高于其他3组(P＜0.05),B组高于C、D组(P＜0.05);在苏醒时间和离室时间上B、C、D组明显优于A组(P＜0.05),C、D组短于B组(P＜0.05).结论 中老年患者在无痛支气管镜检查中可使用瑞芬太尼,且以0.10 μg·kg-1·min-1的瑞芬太尼复合异丙酚麻醉效果较好.

Clinical application of remifentanil in painless bronchoscopic examination of elderly patients

Objective To investigate the effects of remifentanil in painless bronchoscopic examination of elderly panents.Methods One hundred and twenty elderly patients undergoing painless bronchoscopic examination were randomly divided into 4 groups (n=30),the group A was administered with propofol and the groups B,C and D were administered with propofol and remifentanil(remifentanil dose:0.05 μg · kg-1 · min-1 in the group B,0.10μg · kg-1 · min-1 in the group C and 0.15 μg · kg-1 · min-1 in the group D).The body moving response,hemodynamic changes,propofol dose,examination time,wake-up time,departure time and adverse reactions in each group were observed during the examination process.Results During the examination process,the body moving response and bucking of the group A were significantly higher than those of the other three groups(P＜0.05);in hemodynamics,the group A fluctuated greatly,while the group B,C and D were relatively stable,but the incidence rate of hypotension,bradycardia and transient respiratory depressionof the group D were higher than those of the other three groups(P＜0.05);propofol dose of the group A was significantly higher than that of the other three groups (P＜0.05)and the group B was higher than the group C and D(P＜0.05).In wake-up time and departure time,the groups B,C,D were significantly better than the group A(P＜0.05),while the group C and D were better than the group B(P＜0.05).Conclusion Remifentanil can be used in painless bronchoscopic examination for elderly patients,and the effect is better by using propofol combined with remifentanil at a dose of 0.1 μg · kg-1 · min-1.