摘要
目的评价丙泊酚-芬太尼麻醉下纤维支气管镜(FOB)检查术改良面罩通气的效果。方法择期行FOB检查术患者86例,ASAⅠ或Ⅱ级,男女不限,年龄(60.6±10.3)岁。所有患者分为三组:利多卡因表面麻醉组(A组,n=20),丙泊酚-芬太尼麻醉组(B组,n=36)和丙泊酚-芬太尼麻醉联合改良面罩组(C组,n=30)。监测和记录检查前(T1)、FOB刚进入声门时(T2)、FOB触碰气管隆突时(T3)、拔出FOB后即刻(T4)和患者清醒后5 min时(A组检查结束后10 min,T5)的SBP、DBP、HR和SpO2;于T1、T3、T5时采集动脉血样进行血气分析,测定PaO2、PaCO2和pH;于T1、T5时采集静脉血样,测定血浆皮质醇和血糖浓度。结果 T3、T4时A组SBP、DBP明显高于C组,HR明显快于C组(P<0.05)。T3时B组PaO2明显低于A、C组,PaCO2明显高于A、C组(P<0.05)。T5时A组皮质醇和血糖均显著高于B、C组和T1时(P<0.05)。结论 FOB检查术患者丙泊酚-芬太尼麻醉下改良面罩通气效果良好,可以在临床推广应用。
Objective To study the ventilation effects of improved mask on the patients with fiberopic bronchoscopy （FOB） under propofol-fentanyl anesthesia. Methods Eighty-six patients undergoing selective bronchofiberscopy with ASA Ⅰ or Ⅱ, including 47 males and 39 females, aged at （60. 6±10.3） years old, were divided into three groups： lidocaine topical anesthesia group （group A）, propofol-fentanyl anesthesia group （group B） and group of propofol-fentanyl anesthesia with improved mask （group C）. SBP, DBP, MAP, HR and SpO2 were monitored before examination （basic state, T1 ）, at the time of just entering into the glottis （T2）, FOB touching the tracheal carina （T3）, immediately after pulling out FOB （T4） and 5 min after the patient came round （10 min after the examination for group A was closed） （T5） ; samples of arterial blood were collected at T1, T3 and T5 to conduct the analysis of arterial blood gas and to determine the arterial PaO2, PaCO2 and pH value; samples of venous blood were collected at T1 and T5 to determine the plasma cortisol and blood glucose concentration. Results Compared to group C, the SBP, DBP and HR at T3 and T4 was much higher in group A （P〈0.05）. At the time of T3, PaO2 in group B was significantly lower than that in group A and group B, and PaCO2 was much higher in group B （P〈0. 05）. Compared with T1 and group B and group C, cortisol and glucose concentration in group A was significantly higher at T5 in group A （P〈0. 05）. Conclusion The improved mask has a good ventilation effect on the patients with fiberopic bronchoscopy under propofol-fentanyl anesthesia and can be used widely in clinic.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2011年第8期744-746,共3页
Journal of Clinical Anesthesiology
