右美托咪啶联合芬太尼用于肺功能减退老年患者无痛纤维支气管镜检

摘要

Objective To investigate the effect and safety of anaesthesia using dexmedetomidine and fentanyl in fiberoptic bronchoscopy in elderly patients with pulmonary dysfunction.Methods Eighty elderly patients with pulmonary dysfunction were anaesthesized devided into two groups before fiberoptic bronchoscopy:propofol plus fentanyl(group A,n=40) and dexmedetomidine plus fentanyl(group B,n=40).The changes of BP,H R and SpO2 before and after anaesthesia and during fiberoptic bronchoscopy,as well as adverse events after anaesthesia and during bronchoscopy were recorded.Results The baseline values of vital signs before anaesthesia were not significantly different between the two groups(P＞ 0.05).After anaesthesia to during bronchoscopy,SBP,DBP,HR and SpO2 decreased in both groups,but more significantly in group A after anaesthesia(P＜0.05).During bronchoscopy,There were no significalt difference whether in comparison with before anaesthesiaor or between the two groups during bronchoscopy(P＞0.05),and adverse reaction were similar in both groups.Conclusion Anaesthesia under dexmedetomidine combined with fentanyl in fiberoptic bronchoscopy in elderly patients with pulmonary dysfunction is safe and effective.%目的 探讨右美托咪啶联合芬太尼用于肺功能减退老年患者支气管镜检查的效果及安全性.方法 肺功能减退需行纤维支气管镜检查的老年患者80例分为丙泊酚联合芬太尼组(A组)和右美托咪啶联合芬太尼组(B组),每组40例.观察记录两组患者麻醉前后、镜检中的血压(BP)、心率(HR)和血氧饱和度(SpO2)的变化及各种不良反应.结果 两组患者的生命体征基础值间比较差异无统计学意义(P＞0.05)；诱导后至镜检过程中两组患者的收缩压(SBP)、舒张压(DBP)、HR、SpO2均有所下降,但与麻醉前比较,A组于诱导后下降更明显(P＜0.05)；镜检过程中A、B两组无论是与麻醉前还是组间比较差异均无统计学意义(P＞0.05),出现的各种不良反应B组与A组并无显著性差异(P＞0.05).结论 在内镜面罩供氧的前提下,使用右美托咪啶联合芬太尼用于肺功能减退老年患者纤维支气管镜检查是安全和有效的.