右美托咪定联合丙泊酚和舒芬太尼在电子支气管镜检查中的临床研究

目的 研究右美托咪定联合丙泊酚和舒芬太尼的麻醉方法在支气管镜检查中的安全性与有效性，以及在临床中的应用价值。方法 将接受支气管镜检查的60例患者随机分为两组：右美托咪定联合丙泊酚和舒芬太尼组（DPS组：n=30，1 μg/kg的右美托咪定静脉泵注10 min，在泵注5 min时静脉注射舒芬太尼0.1 μg/kg）和丙泊酚复合舒芬太尼组（PS组：n=30，0.25 ml/kg的生理盐水静脉泵注10 min，术前5 min静脉注射舒芬太尼0.1 μg/kg），使用丙泊酚行麻醉诱导和维持。结果 DPS组的MOAA/S评分在T2、T3高于PS组（P＜0.05），在T4、T5、T6则低于PS组（P＜0.05）；DPS组的Ramsay评分在T1时高于PS组（P＜0.05）；PS组的HR在T5、T6高于DPS组（P＜0.05），其SpO2在T3至T5低于DPS组（P＜0.05）；DPS组的DBP和SBP在T5、T6低于PS组（P＜0.05）；DPS组丙泊酚消耗量低于PS组（P＜0.05），而患者的麻醉苏醒时间较PS组长（P＜0.05）；DPS组的呛咳发生情况优于PS组（P＜0.05），但低血压的发生高于PS组（P＜0.05）；DPS组的气管镜医师满意度评分高于PS组。 结论 右美托咪定联合丙泊酚和舒芬太尼的麻醉方法在无痛气管镜检查中是安全、有效的，能够为患者提供稳定的血流动力学和较深的镇静水平。

Clinical study of dexmedetomidine combined with propofol and sufentanil in painless flexible bronchoscopy

Objective To study the safety and effectiveness of dexmedetomidine combined with propofol and sufentanil anesthesia in bronchoscopy and their clinical value. Methods Sixty patients who accepted bronchoscopic examination were randomly divided into two groups: DPS group（Dexmedetomidine combined with propofol and sufentanil group, n=30, 1 μg/kg dexmedetomidine intravenous infusion for 10 minutes and intravenous infusion of 0.1 μg/kg sufentanil for 5 minutes.) and PS group (Propofol combined with sufentanil, n=30, 0.25 ml/kg saline was infused intravenously for 10 minutes and intravenous infusion of 0.1 μg/kg sufentanil for 5 minutes before operation), then propofol was used to induce and maintain anesthesia. Results The MOAA/S score of DPS group was higher than that of PS group at T2 and T3 time points (P<0.05), and it was lower than that of PS group at T4, T5 and T6 time points (P<0.05); Ramsay score of DPS group was higher than that of PS group at T1 time point (P<0.05); HR of PS group was higher than that of DPS group at T5 and T6 time points (P<0.05). At T3, T4 and T5 time points, SpO2 was lower than DPS group (P<0.05); DBP and SBP of DPS group were lower than those of PS group at T5 and T6 time points (P<0.05); propofol consumption of DPS group was lower than that of PS group (P<0.05), and anesthesia recovery time of DPS group was longer than PS group (P<0.05). The incidence of cough in DPS group was less than that in PS group (P<0.05), but the incidence of hypotension was higher than that in PS group (P<0.05). The satisfaction score of physicians of DPS group was higher than that in PS group. Conclusion The anesthesia method of dexmedetomidine combined with propofol and sufentanil is safe and effective in painless flexible bronchoscopy, which can provide stable hemodynamics and deep sedation for patients.