异丙酚、咪达唑仑在纤维支气管镜检查中的镇静作用比较

目的比较异丙酚和咪达唑仑在纤维支气管镜检查中实施镇静的效果以及患者的满意程度。方法 68例支气管镜检患者随机分为异丙酚组（P组）和咪达唑仑组（M组）。在利多卡因局麻后,P组首次静脉缓慢注入异丙酚1.5mg·kg-1,速度为40～60s,然后以5～10mg/（kg·h）输注;M组首次静脉注入咪达唑仑2mg,2min后根据镇静情况追加,每次追加0.5mg,间隔2min。维持用药均根据镇静分级调整,使患者镇静程度位于闭眼入睡和大声指令可唤醒之间。观察镇静诱导时间、意识恢复时间、低氧血症发生率、咳嗽程度、局麻药物追加量以及患者的满意度。结果两组患者的镇静诱导时间分别为48±16s（P组）、210±49s（M组）,意识恢复时间分别为4.9±1.8min（P组）、15.1±5.7min（M组）,镇静诱导时间和意识恢复时间P组均明显短于M组,差异具有统计学意义（P〈0.05）。两组患者低氧血症发生率、咳嗽程度、局麻药物追加量以及患者满意度比较,均无明显差异（P〉0.05）。结论异丙酚、咪达唑仑均可安全用于纤维支气管镜检查镇静,但异丙酚镇静诱导时间短,意识恢复迅速。

Comparison of propofol with midazolam propofol for sedation in fiberoptic bronchoscopy

OBJECTIVE To compare the sedation effects and patient satisfaction of propofol with midazolam in fiberoptic bronchoscopy.METHODS Sixty-eight patients undergoing fiberoptic bronchoscopy were randomly divided into propofol group（P group）and midazolam group（M group）.After topical lidocaine anesthesia,the patients in group P were administered intravenous injection of propofol by the initial dose of 1.5mg·kg-1,slowly with the speed of 40～60s,then 5 ～ 10mg/（kg·h） infusion;The patients in Group M were given intravenous midazolam of 2mg bolus,and after 2min were given increments of 0.5mg,interval 2min.Maintenance of medication were adjusted according to sedation grade of the patients so that the sedation state was between sleep with eyes closed and wake-up under loud command.Sedation induction time,consciousness recovery time,the incidence of hypoxemia,cough degree,the requirement dose of local anesthesia drug,as well as the patient satisfaction.RESULTS The sedation induction time were 48±16s（P group）,210±49 s（M group）,the awareness recovery time were 4.9±1.8min（P group）,15.1±5.7min（M group）,the sedation induction time and the awareness recovery time in group P were significantly shorter than group M,the difference was significant（P0.05）.The diffences of the incidence of hypoxemia,cough degree,requirement dose of local anesthesia drug,as well as patients satisfaction between two groups were no significant（P0.05）.CONCLUSION Propofol and midazolam are safe for fiberoptic bronchoscopy sedation,but the sedation induction time was short time with propofol,the patients with propofol restored consciousness rapidly.