咪达唑仑-芬太尼复合麻醉在无痛电子支气管镜检查中的镇静作用及安全性观察

摘要

目的：：评价咪达唑仑-芬太尼复合麻醉在电子支气管镜检查中的镇静作用及安全性。方法：行电子支气管镜检查患者104例,随机分为咪达唑仑-芬太尼组( A组)和常规对照组( B组)各52例。所有患者检查前常规以2％利多卡因喷鼻腔、咽喉部4次,表面局部麻醉,1.5 ml/min静脉输注0.9％氯化钠注射液。 A组检查前5 min缓慢静脉输注咪达唑仑3.0 mg+芬太尼50μg；B组输注0.9％氯化钠注射液5 ml。2组患者均在用药后2 min进行电子支气管镜检查。记录2组患者用药前( T0)、用药后2 min( T1)、用药后5 min( T2)、用药后10 min( T3)、用药后15 min( T4)及用药后30 min( T5)的收缩压( SBP)、平均动脉压( MAP)、呼吸( RR)、心率( HR)和血氧饱和度( SpO2)及患者呛咳、恶心呕吐、憋气、中断检查及不良记忆等不适反应。结果：A组T1~T3 SBP、T1~T4 MAP和HR均较T0降低(P0.05)。 B组患者T1~T4 MAP和HR均较T0和A组增高(P0. 05). The MAP and HR at T1 to T4 in B group were higher than those at T0 in B group and A group(P <0. 05 to P <0. 01). Compared with T0,the SpO2 in two groups decreased(P<0. 01),but the SpO2 at T1 to T4 in B group were lower than those in A group(P<0. 01). The incidence rates of choke, cough,nausea,vomiting,bad breath and memory in B group were higher than those in A group(P<0. 05 to P<0. 01),The check in 8 cases of B group were interrupted by the excessive stimulus. Conclusions:The compound anesthesia of midazolam-fentanyl is an ideal clinical sedation drug in patients detected by the electronic bronchoscopy.