三通喉罩配合丙泊酚和瑞芬太尼靶控麻醉在电子支气管镜检查中的临床观察

目的观察三通喉罩配合丙泊酚和瑞芬太尼靶控麻醉在电子支气管镜检查中的临床效果。方法将60例须行电子支气管镜检查的患者随机分为观察组和对照组,各30例。观察组在双向靶控泵静脉注射丙泊酚及瑞芬太尼行麻醉后,先插入喉罩并经三通连接管连接呼吸机,之后,电子支气管镜由三通连接管的密封帽膜孔进入,行电子支气管镜检查;对照组在通过双向靶控泵静脉注射丙泊酚及瑞芬太尼进行麻醉后,电子支气管镜由鼻腔进入,行电子支气管镜检查。采用多功能监护仪监测患者血氧饱和度(SaO2)、心率、血压及其波动值。结果观察组SaO2、心率、收缩压波动值变化明显优于对照组,术中观察组的SaO2、心率、血压较对照组稳定(P<0.05),且在并发症、安全性、舒适性方面优于对照组(P<0.01)。结论改变电子支气管镜进镜的途径可提高患者的安全性和舒适性,建议在无痛麻醉(丙泊酚与瑞芬太尼麻醉)电子支气管镜检查中推广应用,并建立无痛电子支气管镜的规范化操作流程。

Clinical Observation of Three-way Laryngeal Mask with Propofol and Remifentanil Target-controlled Anesthesia in Electronic Bronchoscopy

Objective To observe the clinical effects of three-way laryngeal mask along with target controlled anesthesia with propofol and remifentanil in the electronic bronchoscopy.Methods 60 cases which needed electronic bronchoscopy were randomly divided into observation group and control group,30 cases in each group.After injection of propofol and remifentanil by bidirectional target-controlled pump,observation group were inserted the laryngeal mask and connecting tube to connect the ventilator and were inserted the electronic bronchoscopy through the connect of three ways for further examination.Control group,by the same anesthesia,but were inserted electronic bronchoscope into the trachea from the nasal cavity.All cases were monitored oxygen saturation(SaO2),heart rate,blood pressure and its fluctuations by multifunctional monitors.Results SaO2,heart rate,blood pressure fluctuations changes of observation group were significantly better than the control group(P<0.05).SaO2,heart rate,blood pressure during operation were more stable in the observation group than in the control group(P<0.01).Conclusion Changing the electronic bronchoscopy insert approach into the trachea can improve safety and comfort for patients,so it is suggested to popularize the painless electronic bronchoscopy and set up the standard operation process in the clinical practice.