咪达唑仑复合丙泊酚在小儿支气管镜检查中的应用

目的 观察和比较咪达唑仑复合丙泊酚用于小儿支气管镜检查及气管异物取出术的效果.方法 选择住院行支气管镜检查及异物取出术患儿60例,随机分为咪达唑仑-氯胺酮麻醉组(K组)和咪达唑仑-丙泊酚麻醉组(P组),每组各30例.每组均缓慢静脉注射咪达唑仑0.1～0.15 mg/kg,予面罩吸氧5～10min后,K组缓慢静脉注射氯胺酮2 mg/kg,置镜后视情况按1～2 mg/kg追加;P组缓慢静脉注射丙泊酚2 mg/kg,置镜后视情况按1～2 mg/kg追加.观察麻醉后术前、置镜时、术中、术后BP、HR、SpO2、RR、有无屏气、呛咳、术后喉水肿、舌后坠等情况.结果 两组患儿置镜前置镜后,MAP、HR、数值P组均显著低于K组(P＜0.05);P组置镜后MAP、HR均显著下降(P＜0.05),而K组HR不明显,MAP显著上升(P＜0.05);P组置镜后,RR较入室时显著下降(P＜0.05),且明显低于K组(P＜0.05);两组SpO2无差异.K组置镜时屏气、术中屏气,术后舌后坠、喉水肿、苏醒期屏气等并发症明显高于P组(P＜0.05),苏醒时间较P组明显延迟(P＜0.05).结论 咪达唑仑.丙泊酚用于小儿支气管镜检查及气管异物取出术优于咪达唑仑-氯胺酮麻醉效果.

Application of propofol combined with midazolam in the bronchoscope of children

Objective To observe and compare the anesthesia effect of propofol combined with midazolam used in the bronchoscopes and the removal of children's intratraeheal foreign body.Methods 60 patients in hospital were choser to do the operation of bronchoscopes and the removal of children's intratracheal foreign body,the patients of selective operation were randomized into K group(n=30)related to midazolam-ketamine and P group(n=30)related to midazolam-propofol.The patients were respectively injected midazolam slowly given in a dose of 0.1～0.15mg/kg,and then offer oxygen 5～10 minutes with a face mask.After that the patients in group K were injected ketamine slowly in the dose of 2mg/kg,and 1～2mg/kg after laying the bronchoscope according as ease.The patients in group P were injected propofol slowly in the dose of 2mg/kg also,add 1～2mg/kg according as case.Observing the patients' BP,HR,SpO2,RR and if or not holding breath,bucking,postoperation laryngeal edema,glossocoma at the different periods:preoperation,laying the bronehoscope,during the operation and after the operation.Results To compare the two groups,the MAP,HR of group P are lower obviously than group K before and after laying the bmnchoscope(P＜0.05).The HR,MAP of groug P descended significantly after laying bronchoscope(P＜0.05),while the HR fluctuate little but MAP ascend significantly in the group K(P＜0.05).After laying bronchoscope the RR descend significantly than that when patients entered operation room(P＜0.05),and also lower than that ofgroup K(P＜0.05).The SpO2 in the two groups have no difference.The complications as holding breath,postoperative glossocema,laryngeal edema,holding breath during reviving time,in the group K happened at a high rate than the group P(P＜0.05),the awaking time is also longer in the former(P＜0.05).Conclusion The anesthesia effect of midazolam-propofol is superior to that of midazdam-ketamine in the removal of children's intratraeheal foreign body.