局部麻醉联合静脉镇静镇痛在支气管镜检查中的应用效果观察

目的 探讨局部麻醉联合静脉镇静镇痛在支气管镜检查中的临床效果。方法 抽取2018年1月～2020年1月在景德镇市第一人民医院呼吸内科进行支气管镜检查的80例患者,双盲法随机分为A组和B组,每组40例。A组采用2%利多卡因局部雾化麻醉,B组在A组的基础上再推注芬太尼+咪哒唑仑,比较两组用药前(T0)、进入声门时(T1)、抵达隆突时(T2)、取镜时(T3)的心率(HR)、平均动脉压(MAP)、血氧饱和度(SPO2)变化情况,进入声门时间、检查时间、不良反应等。结果 A组T1、T2、T3的HR、MAP明显高于T0,而SPO2低于T0,与用药前比较差异有统计学意义(P0.05),且用药后各时间段HR、MAP高于B组,而SPO2低于B组,两组比较差异有统计学意义(P0.05)。而B组用药前后HR、MAP、SPO2较为平稳,差异无统计学意义(P0.05)。B组进入声门时间及检查时间短于A组,两组比较差异有统计学意义(P0.05)。A组不良反应发生率高于B组,两组比较差异有统计学意义(P0.05)。结论 支气管镜检查中采用局麻联合静脉镇静镇痛能够明显减轻患者痛苦,提高耐受度,从而确保检查的安全性及有效性。

Observation on the application effect of local anesthesia combined with intravenous sedation and analgesia in bronchoscopy

Objective To explore the clinical effect of local anesthesia combined with intravenous sedation and analgesia in bronchoscopy. Methods A total of 80 patients who were given bronchoscopy in the Department of Respiratory Medicine in Jingdezhen No.1 People''s Hospital from January 2018 to January 2020 were selected. The double-blind method was used to randomly divide the patients into group A and group B, with 40 cases in each group. Group A was given 2% lidocaine local atomization for anesthesia, and group B was further given fentanyl + midazolam on the basis of group A. The changes of heart rate(HR), mean arterial pressure(MAP), and blood oxygen saturation(SPO2) before medication(T0), when entering the glottis(T1), when reaching the carina(T2), and when taking the lens(T3) were compared between the two groups. The time spent to enter the glottis, inspection time, and adverse reactions were also compared between the two groups. Results The HR and MAP at T1, T2 and T3 in group A were significantly higher than that those at T0, and SPO2 was lower than that at T0. The differences compared to those before administration were statistically significant(P<0.05), and the HR and MAP in each time period after administration were higher than those in group B,while SPO2 was lower than that in group B. The difference between the two groups was statistically significant(P<0.05).HR, MAP, and SPO2 before and after administration in group B were relatively stable, and there was no statistically significant difference(P>0.05). The time spent to enter the glottis and the inspection time in group B were shorter than those in group A, and the differences between the two groups were statistically significant(P<0.05). The incidence rate of adverse reactions in group A was higher than that in group B, and the difference between the two groups was statistically significant(P<0.05). Conclusion The application of local anesthesia combined with intravenous sedation and analgesia in bronchoscopy can significantly reduce the patient''s pain and improve tolerance, so as to ensure the safety and effectiveness of the inspection.