于淼

[摘要] 目的 探討纤维支气管镜清醒插管时靶控输注瑞芬太尼的效果。 方法 选择我院2019年2月至2020年5月收治的纤维支气管镜清醒插管患者66例进行研究，以随机数字表法分为两组，每组各33例。对照组用瑞芬太尼持续输注，观察组用瑞芬太尼靶控输注，比较两组输注瑞芬太尼2、4、8 min时OAA/S评分、纤维支气管镜置入时间、气管导管置入时间及苏醒时间。 结果 输注2 min时，观察组OAA/S评分为（3.48±0.63）分，对照组则为（3.40±0.66）分，差异无统计学意义（P>0.05），输注4、8 min时两组患者OAA/S评分均有明显降低，组内比较，差异有统计学意义（P<0.05），输注4、8 min时观察组分别为（1.69±0.32）分、（1.10±0.20）分，对照组依次为（2.33±0.49）分、（1.73±0.38）分，组间比较，差异有统计学意义（P<0.05）;观察组纤维支气管镜置入时间、气管导管置入时间及苏醒时间分别为（150.42±45.33）s、（64.06±40.35）s、（7.67±3.54）min，对照组依次为（176.17±50.35）s、（94.21±47.37）s、（14.61±5.52）min，差异有统计学意义（P<0.05）。 结论 纤维支气管镜清醒插管时靶控输注瑞芬太尼，与持续输注比较，可缩短纤维支气管镜置入时间、气管导管置入时间及苏醒时间，同时提高镇静效果。

[关键词] 纤维支气管镜;清醒插管;持续输注;靶控输注;瑞芬太尼

[中图分类号] R614.3          [文献标识码] B          [文章编号] 1673-9701（2021）35-0130-04

Research on the efficacy of target-controlled infusion of remifentanil during awakening intubation under fiberoptic bronchoscopy

YU Miao

Department of Anesthesiology， Affiliated Central Hospital of Shenyang Medical College， Shenyang 110024， China

[Abstract] Objective To investigate the efficacy of target-controlled infusion （TCI） of remifentanil during awakening intubation under fiberoptic bronchoscopy. Methods A total of 66 patients with awakening intubation under fiberoptic bronchoscopy admitted to and treated in our hospital from February 2019 to May 2020 were selected as the research object， and they were divided into the control group （n=33） and the observation group （n=33） according to the random number table method. The control group was treated with continuous infusion of remifentanil， while the observation group was treated with TCI of remifentanil. The OAA/S scores of remifentanil for 2， 4 and 8 min， the intubation time， the recovery time of fiberoptic bronchoscopy and endotracheal tube between the two groups were compared. Results After 2 min of infusion， the OAA/S scores of the observation group and the control group were （3.48±0.63） points and （3.40±0.66） points， respectively， without statistically significant difference（P>0.05）. After 4 and 8 min of infusion， the OAA/S scores of patients in the two groups both decreased significantly， with statistically significant differences in each group （P<0.05）. After 4 and 8 min of infusion， the scores were （1.69±0.32） points and （1.10±0.20） points in the observation group， and （2.33±0.49） points and （1.73±0.38） points in the control group， respectively， with statistically significant differences between the two groups （P<0.05）. The intubation time and the recovery time of fiberoptic bronchoscopy and endotracheal tube in the observation group were （150.42±45.33） s， （64.06±40.35） s and （7.67±3.54） min， while those in the control group were （176.17±50.35） s， （94.21±47.37） s and （14.61±5.52） min， respectively， with statistically significant differences （P<0.05）. Conclusion Compared with continuous infusion， TCI of remifentanil during awakening intubation of fiberoptic bronchoscopy can shorten the intubation time and recovery time of fiberoptic bronchoscopy and endotracheal tube， and simultaneously improve the sedative efficacy.

[Key words] Fiberoptic bronchoscopy; Awakening intubation; Continuous infusion; Target-controlled infusion; Remifentanil

纤维支气管镜是临床诊断与治疗呼吸系统疾病、肺部病变比较有效的技术，甚至成为一些疾病诊治的首选方案，证实有不错的临床应用价值[1]。从近年临床研究报道中发现，纤维支气管镜诊治中，大多数选择局部麻醉处理，这类麻醉方案有一定的作用，但容易诱发患者心理恐惧、窒息感、呛咳、屏气等发生[2]，严重情况有心脑血管意外事件发生，加上该操作自身又是侵袭性操作，一些患者难以接受[3]。……