丙泊酚及咪达唑仑复合瑞芬太尼在纤维支气管镜检查中的效果观察

目的：探讨丙泊酚及咪达唑仑复合瑞芬太尼麻醉在纤维支气管镜检查中的效果及安全性。方法选择接受纤维支气管镜检查患者264例，随机分为观察组及对照组，各132例，对照组给予局部表面麻醉，观察组给予丙泊酚及咪达唑仑复合瑞芬太尼静脉诱导麻醉，记录术前及术中MAP、HR及SpO2的变化；评价麻醉效果；调查知晓率及满意度及比较不良反应的发生率。结果对照组4例插管失败，观察组均完成检查。术前血压（ MAP）、心率（ HR）及血氧饱和度（ SpO2）水平两组比较，差异均无统计学意义（P＞0．05）；检查中MAP、HR最高值及SpO2最低值两组之间比较，均有显著性差异（P＜0．05）；观察组术中MAP较术前降低（P＜0．05），而HR及SpO2较术前无明显变化（P＞0．05）；对照组MAP及HR较术前升高，SpO2较术前降低（P＜0．05）。观察组与对照组麻醉效果比较，差异有显著性（P＜0．05）。满意度调查观察组满意度高于对照组（P＜0．05）。对照组不良反应发生率高于观察组（P＜0．05）。结论丙泊酚及咪达唑仑复合瑞芬太尼用于纤支镜检查麻醉是一种安全有效的方法。

Effects of propofol and midazolam combined with remifentanil in bronchoscope examination

Objective To explore the effects and safety of propofol and midazolam combined with remifentanil in bronchoscope exami -nation.Methods Two hundred and sixty-four patients undergoing fiberoptic bronchoscopy were randomized into observation group （n=132 ） and control group （ n=132 ） .The control group was given local anesthesia and the observation group was given intravenous anes-thesia with propofol,midazolam and remifentani.The levels of MAP,HR and SpO2 before and during the operation were recorded .The anaesthetic effects of two therapies were evaluated .The incidences of awareness and satisfaction were investigated and the incidences of adverse reaction were compared between two groups .Results Four cases in the control group fell out .A total of 260 patients completed the study.There were not significant differences between two groups in the levels of MAP ,HR and SpO2 before the operation（P〉0.05）.During the course of the operation there were significant differences between two groups in the maximal value of MAP ,HR and the minimum value of SpO2（P〈0.05）.The level of MAP during the operation decreased in the observation group compared with preo -peration（P〈0.05）.There were no changes in the levels of HR and SpO 2 between before and during the operation （P〉0.05）.The lev-els of MAP and HR in the control group were higher than preoperation （P〈0.05） while the level of SpO2was lower（P〈0.05）.The satisfaction of the observation group was significantly higher and adverse reaction rate was significantly lower than the control group （ P〈0.05）.Conclusions Propofol and midazolam combined with remifentanil for bronchoscopy anesthesia is a safe and effective method .