丙泊酚联合咪达唑仑、瑞芬太尼在纤维支气管镜中运用的临床观察

目的探讨丙泊酚联合咪达唑仑、瑞芬太尼用于纤维支气管镜检查的安全性与可行性。方法拟行纤维支气管镜检查的ASAⅠ～Ⅱ级患者40例，随机分为A组和B组，A组予丙泊酚联合咪达唑仑、瑞芬太尼静脉麻醉；B组仅予局部表面麻醉。观察镜检过程中的多项生命体征变化。结果A组患者在给药后呈一过性心率的减慢、血压降低（P〈0．05），镜检中无明显的不适反应；B组大多数患者镜检过程中心动过速、血压升高（P〈0．05），出现了不同程度的恶心、呕吐、呛咳等不适反应。结论丙泊酚联合咪达唑仑、瑞芬太尼应用于纤维支气管镜检查能发挥良好的麻醉镇痛效果。

The clinical observation of propofol combined with midazolam and remifentanil used in bronchoscopy

Objective To study the safety and feasibility of propofol combined with midazolam and remifentanil used in bronehoseopy. Methods 40 patients of ASA Ⅰ-Ⅱundergoing bronehoseopy were divided into 2 groups randomly. The patients in group A were treated with propofol combined with midazolam and remifentanil,while those in group B treated with topical anesthesia. The life signs were observed in different time. Results After injection before examination, heart rate and blood pressure decreased temporarily in most of patients of group A （P 〈 0.05）. While there was a conspicuous increase in heart rate and blood pressure in the patients of group B （P 〈 0.05）. There was no pain or discomfort in the patients of group A. The phenomena such as nausea and vomition,begma could be found in most of patients of group B. Conclusion Propofol combined with midazolam and remifentanil used in bronehoseopy could offer a good sedation and analgesia.