环泊酚与丙泊酚复合芬太尼在重症监护室清醒患者中行无痛支气管镜检查的应用效果对比

Comparison of the application of Ciprofol and Propofol combined with Fentanyl in painless bronchoscopy for conscious patients in intensive care unit

摘要:

目的 对比环泊酚与丙泊酚复合芬太尼在重症监护室（ICU）清醒患者中行无痛纤维支气管镜检查的麻醉效果和安全性。方法 选取2022年10月－2023年1月该院行无痛纤维支气管镜检査的清醒患者60例。按照随机数表法，分为对照组（丙泊酚1.5 mg/kg + 芬太尼1 μg/kg，30例）和实验组（环泊酚0.4 mg/kg+芬太尼1 μg/kg，30例）。记录两组患者麻醉前（T₁）、检查中（T₂）和检查完成时（T₃）的收缩压、舒张压、心率、呼吸频率和经皮动脉血氧饱和度（SpO₂），比较两组患者全身麻醉诱导成功率、麻醉诱导时间、支气管镜操作时间、睁眼时间、药物使用总量、注射痛发生率和术中不良反应（低血压、呼吸抑制、心动过缓和呛咳）发生率。结果 两组患者不同时点的收缩压、舒张压、心率和呼吸频率的组间、时间和交互作用比较，差异均有统计学意义（P < 0.05）；实验组麻醉诱导时间为1.40（1.10，1.62）min，短于对照组的1.60（1.30，2.10）min，差异有统计学意义（P < 0.05）；实验组药物使用总量为（21.40±1.82）mg，少于对照组的（78.75±6.71）mg，差异有统计学意义（P < 0.05）；实验组注射痛发生率为3.33%，呼吸抑制发生率为6.67%，低于对照组的36.67%和30.00%，差异均有统计学意义（P < 0.05）。结论 环泊酚复合芬太尼用于无痛支气管镜检查，麻醉效果好，安全性高，且不良反应发生率低，值得应用于临床。

Abstract:

Objective To compare the anesthetic effect and safety of Ciprofol and Propofol combined with Fentanyl in painless bronchoscopy for conscious patients in intensive care unit (ICU).Methods 60 conscious patients who underwent painless bronchoscopy from October 2022 to January 2023 were selected. According to the random number table method, 30 cases were divided into the control group (Propofol 1.5 mg/kg + Fentanyl 1 μg/kg) and 30 cases were divided into the experimental group (Ciprofol 0.4 mg/kg + Fentanyl 1 μg/kg). Systolic blood pressure, diastolic blood pressure, heart rate, respiratory frequency, and percutaneous arterial oxygen saturation (SpO₂) were recorded before anesthesia (T₁), during the examination (T₂), and at the completion of the examination (T₃) in the two groups, and the success rate of induction of general anesthesia, the time of induction of anesthesia, the time of bronchoscopy, the time of eye-opening, the total dosage of medications used, the incidence of injection pain, and the incidence of intraoperative adverse reactions (hypotension, respiratory depression, bradycardia, and bucking) in the two groups were compared.Results Analysis of the data revealed significant group, time, and interaction effects for systolic blood pressure, diastolic blood pressure, heart rate, and respiratory frequency at different time points (P < 0.05). The experimental group had a shorter induction time of anesthesia [1.40 (1.10, 1.62) min] in comparison to the control group [1.60 (1.30, 2.10) min] (P < 0.05), and the experimental group required a less amount of drug to achieve the desired outcome [(21.40 ± 1.82) mg ] compared to the control group [(78.75 ± 6.71) mg ] (P < 0.05). Furthermore, the incidence of injection pain (3.33%) and respiratory depression (6.67%) was significantly reduced in the experimental group compared to the control group (36.67%) and (30.00%) (P < 0.05).Conclusion The use of Ciprofol in combination with Fentanyl has been found to provide effective anesthesia during bronchoscopy, while also increasing safety and decreasing the incidence of adverse events. It is worthy of clinical application.