SEDATION FOR FIBEROPTIC BRONCHOSCOPY - COMPARISON OF ALFENTANIL WITH PAPAVERETUM AND DIAZEPAM
SEDATION FOR FIBEROPTIC BRONCHOSCOPY - COMPARISON OF ALFENTANIL WITH PAPAVERETUM AND DIAZEPAM
复制标题
DOI：
10.1016/s0954-6111(89)80034-4
复制
发表时间：
1989-05-01
影响因子：
4.3
通讯作者：
MILLARD, FJC
中科院分区：
文献类型：
--
作者：
WEBB, AR;DOHERTY, JF;MILLARD, FJC
纤维支气管镜检查的镇静应为操作员、患者舒适和快速恢复提供最佳条件，以便早日出院回家。我们比较了产生“浅”镇静的方案和产生“深”镇静的更传统的方案。76例在表面麻醉下行纤维支气管镜检查的患者随机分为两组，分别接受阿芬太尼(中位剂量1.1 mg，0.5~2.6 mg)和罂粟碱(中位剂量10 mg，5~15 mg)和安定(中位剂量8 mg，0~20 mg)的轻度镇静和深度镇静。两种技术都提供了同样好的操作条件，尽管服用阿芬太尼的患者咳嗽次数比服用罂粟碱和安定的患者更少(U=2.814，P<0.01)。患者在镇静前用视觉模拟评分记录他们的恐惧程度，以及恢复后的实际舒适度。两组之间的恐惧或舒适度没有显著差异。这是尽管深度镇静剂组在支气管镜检查中显示的无关物体有更高程度的健忘症(chi.2=21.084 P<；0.001)。服用阿芬太尼的患者在支气管镜检查2小时后的改良龙伯格试验(t=4.357)和目测试验(t=3.035 P<；0.01)中的表现明显更好。与深度镇静方案相比，阿尔芬太尼产生了良好的操作条件、患者舒适度、较少的咳嗽和更快的恢复，是纤维支气管镜检查的理想镇静剂。
Sedation for fibreoptic bronchoscopy should produce optimal conditions for the operator, patient comfort and rapid recovery allowing early discharge home. We have compared a regimen producing ''light'' sedation with a more traditional regimen producing ''deep'' sedation. Seventy-six patients undergoing fibreoptic bronchoscopy under topical anaesthesia were randomized to receive either light sedation with the short acting opiate, alfentanil (median dose 1.1 mg, range 0.5-2.6 mg) or deep sedation with a combination of papaveretum (median dose 10 mg, range 5-15 mg) and diazepam (median dose 8 mg, range 0-20 mg). Both techniques gave equally good operating conditions, although patients given alfentanil coughed less than those given papaveretum and diazepam (U = 2.814 P < 0.01). Patients recorded their degree of apprehension on a visual analogue scale prior to sedation and the actual degree of comfort experienced after recovery. There was no significant difference between apprehension or comfort between the groups. This was despite a higher degree of amnesia for an irrelevant object shown during the bronchoscopy in the deeply sedated group (.chi.2 = 21.084 P < 0.001). Patients given alfentanil performed significantly better in a modified Romberg test (.chi.2 = 4.357 P < 0.05) and a visualisation test (t = 3.035 P < 0.01) two hours after the bronchoscopy. Alfentanil produced good operating conditions, patient comfort, less cough and a more rapid recovery, compared to the deep sedation regimen, and is an ideal sedative for fibreoptic bronchoscopy.