Application of Dexmedetomidine Anesthesia for Fiberoptic Bronchoscopy with a Target-controlled Infusion of Propofol　P. R. China_West China Medical Journal

Authors：

LI Wei , LIU Wenzhi , ZHU Yuehao , GAO Lunming , LI Lihua , CHENG Jun , TAO Guanghua.

Department of Anesthesiology, Chinese Traditional and Western Medicine Hospital, Panzhihua University, Panzhihua, Sichuan 617000,;

Corresponding?author：

Keywords：

右美托咪定; 丙泊酚; 靶控輸注; 纖維支氣管鏡檢查

DOI：

10.7507/1002-0179.20130123

Video：

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目的　觀察右美托咪啶復合丙泊酚靶控靜脈麻醉在纖維支氣管鏡檢查術中的麻醉效果。方法　2010年12月－2012年4月，將60例行纖維支氣管鏡檢查術的患者隨機分為丙泊酚麻醉組（對照組）和右美托咪啶復合丙泊酚麻醉組（觀察組），每組各30例。觀察記錄不同時點平均動脈壓（MAP）、心率、呼吸次數（RR）、脈搏血氧飽和度（SpO2），鎮靜評分、手術時間、蘇醒時間、丙泊酚總用量、不良反應發生率及患者滿意度。結果　所有患者均能順利完成操作，誘導入睡后觀察組MAP、心率下降（P＜0.05），丙泊酚總用量、不良反應發生率均少于對照組（P＜0.05），鎮靜評分優于對照組（P＜0.05）；兩組RR、SpO2、蘇醒時間、手術時間及患者滿意度差異無統計學意義（P＞0.05）。結論　右美托咪定復合丙泊酚靶控輸注適用于纖維支氣管鏡檢查術麻醉，是一種更加安全有效的麻醉方法。

Citation： LI Wei,LIU Wenzhi,ZHU Yuehao,GAO Lunming,LI Lihua,CHENG Jun,TAO Guanghua.. Application of Dexmedetomidine Anesthesia for Fiberoptic Bronchoscopy with a Target-controlled Infusion of Propofol　P. R. China. West China Medical Journal, 2013, 28(3): 387-390. doi: 10.7507/1002-0179.20130123 Copy

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2.	Bergese SD, Candiotti KA, Bokesch PM, et al. A phaseⅢb, randomized, double-blind, placebo-controlled, multicenter study evaluating the safety and efficacy of dexmedetomidine for sedation during awake fiberoptic intubation[J]. Am J Ther, 2010, 17(6): 586-595.
3.	Patel A, Davidson M, Tran MC, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy[J]. Anesth Analg, 2010, 111(4): 1004-1010.
4.	胡憲文, 張野, 孔令鎖, 等. 不同劑量右美托咪啶抑制氣管插管誘發患者心血管反應效應的比較[J]. 中華麻醉學雜志, 2010, 30(11): 1304-1306.
5.	林生, 倪淑芹, 孫東秀, 等. 右美托咪啶-異丙酚-芬太尼復合麻醉對頸椎手術病人體感誘發電位及運動誘發電位的影響[J]. 中華麻醉學雜志, 2010, 30(11): 1284-1286.
6.	Dutta S, Karol MD, Cohen T, et al. Effect of dexmedetomidine on propofol requirements in healthy subjects[J]. J Pharm Sci, 2001, 90(2): 172-181.
7.	苑進革, 陳永學, 趙森波, 等. 右美托咪定注射液的臨床應用進展[J]. 山東醫藥, 2012, 52(44): 100-103.
8.	Szumita PM, Baroletti SA, Ke AE, et al. Sedation and analgesia in the intensive care unit: evaluating the role of dexmedetomidine[J]. Am Health Syst Pharm, 2007, 64(1): 37-44.
9.	李民, 張利萍, 吳新民. 右美托咪啶在臨床麻醉中應用的研究進展[J]. 中國臨床藥理學雜志, 2007, 23(6): 466-470.
10.	孫捷豪, 韓寧, 吳秀英. 右美托咪啶用于全身麻醉的隨機對照試驗的Meta分析[J]. 中國循證醫學雜志, 2008, 8(9): 773-780.
11.	Al-Zaben KR, Qudaisat IY, Al-Ghanem SM, et al. Intraoperative administration of dexmedetomidine reduces the analgesic requirements for children undergoing hypospadius surgery[J]. Eur J Anaesthesiol, 2010, 27(3): 247-252.
12.	Lin TF, Yeh YC, Lin FS, et al. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia[J]. Br J Anaesth, 2009, 102(1): 117-122.
13.	Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. their pharmacology and therapeutic role[J]. Anaesthesia, 1999, 54(2): 146-165.
14.	Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. Their pharmacology and therapeutic role[J]. Anaesthesia, 1999, 54(2): 146-165.
15.	Hall JE, Uhrich TD, Barney JA, et al. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions[J]. Anesth Analg, 2000, 90(3): 699-705.
16.	Jalowiecki P, Rudner R, Gonciarz M, et al. Sole use of dexmedetomidine has limited utility for conscious sedation during outpatient colonoscopy[J]. Anesthesiology, 2005, 103(2): 269-273.
17.	Lam SW, Alexander E. Dexmedetomidine use in critical care[J]. AACN Adv Crit Care, 2008, 19(2): 113-120.
18.	Abouzgheib W, Littman J, Pratter M, et al. Efficacy and safety ofdexmedetomidine during bronchoscopy in patients with moderate to severe COPD or emphysema[J]. J Bronehol, 2007, 14(4): 233-236.
19.	Wiklund RA. Fentanyl or dexmedetomidine combined with desflurane for bariatric surgery[J]. Survey Anesthesiol, 2007, 51(2): 77.
20.	Hofer RE, Sprung J, Sarr MG, et al. Anesthesia for a patient with morbid obesity using dexmedetomidine without narcotics[J]. Can J Anaesth, 2005, 52(2): 176-180.
21.	Ramsay MA, Saha D, Hebeler RF. Tracheal resection in the morbidly obese patient: the role of dexmedetomidine[J]. J Clin Anesth, 2006, 18(6): 452-454.
22.	王克民, 孫艷紅, 侯永強. 鹽酸右美托咪定用于重癥監護患者鎮靜及鎮痛的臨床觀察[J]. 河南科技大學學報·醫學版, 2011, 29(4): 267-271.

1. 　Rutkowska K, Knapik P, Misiolek H. The effect of dexmedetomidine sedation on brachial plexus block in patients with end-stage renal disease[J]. Eur J Anaesthesiol, 2009, 26(10): 851-855.
2. 　Bergese SD, Candiotti KA, Bokesch PM, et al. A phaseⅢb, randomized, double-blind, placebo-controlled, multicenter study evaluating the safety and efficacy of dexmedetomidine for sedation during awake fiberoptic intubation[J]. Am J Ther, 2010, 17(6): 586-595.
3. 　Patel A, Davidson M, Tran MC, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy[J]. Anesth Analg, 2010, 111(4): 1004-1010.
4. 　胡憲文, 張野, 孔令鎖, 等. 不同劑量右美托咪啶抑制氣管插管誘發患者心血管反應效應的比較[J]. 中華麻醉學雜志, 2010, 30(11): 1304-1306.
5. 　林生, 倪淑芹, 孫東秀, 等. 右美托咪啶-異丙酚-芬太尼復合麻醉對頸椎手術病人體感誘發電位及運動誘發電位的影響[J]. 中華麻醉學雜志, 2010, 30(11): 1284-1286.
6. 　Dutta S, Karol MD, Cohen T, et al. Effect of dexmedetomidine on propofol requirements in healthy subjects[J]. J Pharm Sci, 2001, 90(2): 172-181.
7. 　苑進革, 陳永學, 趙森波, 等. 右美托咪定注射液的臨床應用進展[J]. 山東醫藥, 2012, 52(44): 100-103.
8. 　Szumita PM, Baroletti SA, Ke AE, et al. Sedation and analgesia in the intensive care unit: evaluating the role of dexmedetomidine[J]. Am Health Syst Pharm, 2007, 64(1): 37-44.
9. 　李民, 張利萍, 吳新民. 右美托咪啶在臨床麻醉中應用的研究進展[J]. 中國臨床藥理學雜志, 2007, 23(6): 466-470.
10. 　孫捷豪, 韓寧, 吳秀英. 右美托咪啶用于全身麻醉的隨機對照試驗的Meta分析[J]. 中國循證醫學雜志, 2008, 8(9): 773-780.
11. 　Al-Zaben KR, Qudaisat IY, Al-Ghanem SM, et al. Intraoperative administration of dexmedetomidine reduces the analgesic requirements for children undergoing hypospadius surgery[J]. Eur J Anaesthesiol, 2010, 27(3): 247-252.
12. 　Lin TF, Yeh YC, Lin FS, et al. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia[J]. Br J Anaesth, 2009, 102(1): 117-122.
13. 　Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. their pharmacology and therapeutic role[J]. Anaesthesia, 1999, 54(2): 146-165.
14. 　Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. Their pharmacology and therapeutic role[J]. Anaesthesia, 1999, 54(2): 146-165.
15. 　Hall JE, Uhrich TD, Barney JA, et al. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions[J]. Anesth Analg, 2000, 90(3): 699-705.
16. 　Jalowiecki P, Rudner R, Gonciarz M, et al. Sole use of dexmedetomidine has limited utility for conscious sedation during outpatient colonoscopy[J]. Anesthesiology, 2005, 103(2): 269-273.
17. 　Lam SW, Alexander E. Dexmedetomidine use in critical care[J]. AACN Adv Crit Care, 2008, 19(2): 113-120.
18. 　Abouzgheib W, Littman J, Pratter M, et al. Efficacy and safety ofdexmedetomidine during bronchoscopy in patients with moderate to severe COPD or emphysema[J]. J Bronehol, 2007, 14(4): 233-236.
19. 　Wiklund RA. Fentanyl or dexmedetomidine combined with desflurane for bariatric surgery[J]. Survey Anesthesiol, 2007, 51(2): 77.
20. 　Hofer RE, Sprung J, Sarr MG, et al. Anesthesia for a patient with morbid obesity using dexmedetomidine without narcotics[J]. Can J Anaesth, 2005, 52(2): 176-180.
21. 　Ramsay MA, Saha D, Hebeler RF. Tracheal resection in the morbidly obese patient: the role of dexmedetomidine[J]. J Clin Anesth, 2006, 18(6): 452-454.
22. 　王克民, 孫艷紅, 侯永強. 鹽酸右美托咪定用于重癥監護患者鎮靜及鎮痛的臨床觀察[J]. 河南科技大學學報·醫學版, 2011, 29(4): 267-271.

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Application of Dexmedetomidine Anesthesia for Fiberoptic Bronchoscopy with a Target-controlled Infusion of Propofol　P. R. China