连续超声雾化表面麻醉在纤维支气管镜检查术中的应用

目的:探讨连续超声雾化表面麻醉在纤维支气管镜检查术中应用的可行性。方法:60例需做纤维支气管镜检查的患者,根据麻醉方法的不同随机分为A、B两组。A组采用传统的超声雾化表面麻醉,B组在A组基础上进行改良,采用连续超声雾化表面麻醉。观察:①纤维支气管镜检查过程中,患者的血压、心率、呼吸频率和氧饱和度的变化;②检查过程中追加药物次数、药物总量、呛咳程度、操作时间的比较;③麻醉效果。结果:与术前相比,A组术中及术后收缩压明显升高,心率及呼吸频率加快,氧饱和度下降,有显著性差异(P<0.05或P<0.01);与术前相比,B组术中心率及呼吸频率有一过性加快,氧饱和度有一过性下降(P<0.01),术毕恢复正常。与A组相比,B组操作时间明显缩短,追加药物次数及总量明显减少,严重呛咳程度明显降低,组间比较有显著性差异(P<0.01);A组和B组的麻醉优良率分别为30.0%和66.7%,组间比较有显著性差异(P<0.01)。结论:连续超声雾化表面麻醉具有麻醉效果好、插管过程安全、镜检操控性好、患者血流动力学稳定等优点,值得推广使用。

Application of surface anesthesia by continuous ultrasonic atomizing inhalation in fiberoptic bronchoscopy

Objective: To explore the feasibility of surface anesthesia by continuous ultrasonic atomizing inhalation in fiberoptic bronchoscopy.Methods: Sixty patients undergoing fiberoptic bronchoscopy were divided randomly into two groups(group A,B) according to different methods of anesthesia.Patients in group A(control group) practised conventional surface anesthesia by ultrasonic atomizing inhalation;patients in group B(study group) practiced modified surface anesthesia by continuous ultrasonic atomizing inhalation.The follow items of the patients were observed during the examination of fiberoptic bronchoscopy:① Blood pressure(BP),heart rate(HR),respiratory frequency,oxygen saturation;②Times of drug administration,total dose of the drug used,extent of cough,operation time;③Effect of anesthesia.Results: Compared the observed items ① with that before the operation in group A,systolic BP increased apparently during and after operation,HR and respiratory frequency quickened,oxygen saturation decreased during and after the operation.The differences between them were significant(P<0.05 or P<0.01).Compared the observed items ① with that before the operation in group B,HR and respiratory frequency had transient quickened,oxygen saturation had transient decrease during the operation,which recovered to normal soon after the operation.The differences between them were significant(P<0.01).Compared the observed items② in group B with that in group A,the operation time was shortened obviously,times of drug administration reduced obviously,total dose of the drug used reduced obviously,extent of severe cough alleviated apparently.The differences between them were significant(P<0.01).The percentiles of good effect of anesthesia in group A and B were 30.0% and 66.7% respectively;the difference between them was significant(P<0.01).Conclusion: The surface anesthesia by continuous ultrasonic atomizing inhalation was a good method deserving generalization with plenty merits: satisfactory effect of anesthesia,safety for intubation,easy for operation,steady in hemodynamics.