对中重度气道狭窄患者行硬质气管镜检查治疗中无肌松药静脉麻醉的应用效果

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Abstract Objective To evaluate the effect of no-inotropic intravenous anesthesia in the treatment of patients with moderate-to-severe airway stenosis through rigid bronchoscopy.Methods Sixty patients with moderate-to-severe airway stenosis from January 2020 to January 2021 treated through rigid bronchoscopy were randomly divided into no-inotropic group (group A) and the inotropic group (group B). We measured the mean arterial pressure (MAP), heart rate (HR), Bispectral index values (BIS) before induction of anesthesia (T₀), at the time of rigidoscopy placement (T₁), and after rigidoscopy placement (T₂); vocal activity of patients at the time of rigidoscopy placement , choking of patients after rigidoscopy placement, operation time, awakening time, arterial blood gas analysis at the end of operation, intraoperative oxygen saturation below 90% , and the assessment of upper limb muscle strength were also measured.Results 53 patients completed the study, including 27 in the no-myorelaxant group and 26 in the myorelaxant group. There was no difference in the changes of MAP and HR between the two groups before and after rigidoscopy placement and there was no significant difference in operation time and awakening time. The blood gas analysis of lactate (Lac) was higher in group A(1.05±0.4)than in group B(0.8±0.3)(P<0.05). The difference in the incidence of intra operative hypoxemia between the two groups was not statistically significant. The incidence of choking was higher in group A 66.6% than in group B 19.2% (P< 0.05). The upper limb muscle strength against resistance at awakening was significantly better in group A 100% than in group B 46.1% (P<0.05).Conclusions No-inotropic intravenous anesthesia is a safe and feasible technique worth promoting because of the good recovery of patients' muscle strength and the low impact on respiratory function during rigid bronchoscopy treatment in patients with moderate to severe airway stenosis.

Key words： rigid bronchoscopy airway stenosis no-inotropic rocuronium bromide intravenous anesthesia dynamometry

Received: 01 November 2021

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	HOU Qingwu
	XU Jing
	YANG Mingyuan
	YU Xiangdi
	CHENG Qinghao
	WANG Bin

Cite this article:

HOU Qingwu,XU Jing,YANG Mingyuan等. Effect of no-inotropic intravenous anesthesia in treatment of patients with moderate-to-severe airway stenosis through rigid bronchoscopy[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(4): 319-322.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2022/V33/I4/319

[1]	于维霞,王洪武,张楠,等.硬质气管镜及电子支气管镜介入治疗气道良性肿瘤[J].中国临床医师杂志(电子版),2013, 7(1):400-402.
[2]	夏小萍,王尔华,汪小海,等.无肌松药维持下全麻经口双气囊小肠镜检查的随机对照研究[J].中国消化内镜杂志,2019,36(10):750-754.
[3]	Hunter J M. Reversal of residual neuromuscular block: complications associated with perioperative management of muscle relaxation[J].Br J Anaesth,2017,119(Suppl 1):53-62.
[4]	中华医学会呼吸病学分会.良性中心气道狭窄经支气管镜介入诊治专家共识[J].中华结核和呼吸杂志,2017,40(6):408-418.
[5]	Scarlata S,Fuso L, Lucantoni G, et al. The technique of endoscopic airway tumor treatment[J].J Thorac Dis,2017,9(8):2619-2639.
[6]	中国急诊气道管理协助组.急诊气道管理共识[J].中华急诊医学杂志,2016,25(6):705-708.
[7]	王洪武,李冬妹,周云芝,等. 恶性阻塞性全肺不张支气管镜介入治疗的疗效分析[J].国际呼吸杂志,2021,41(10):765-770
[8]	王宇飞,刘琳,褚运松. NPPV对AECOPD合并重度Ⅱ型呼吸衰竭患者PaO2及pH值的影响分析[J].武警后勤学院学报(医学版),2021,30(2):12-15.
[9]	李洪梅,韩旸,王凯亮.2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征持续气道正压通气疗效[J].武警医学,2019,30(10):849-852.
[10]	Jiang Y Q, Xue J S, Xu J, et al. Efficacy of continuous positiveairway pressure treatment in treating obstructive sleep apnea hypopnea syndrome associated with carotid arteriosclerosis[J]. Exp Ther Med,2017, 14(6):6176-6182.
[11]	张杨,陈霞,马浩南. Ambu Auragain喉罩用于无痛纤维支气管镜检查术患者气道管理的效果[J].中华麻醉学杂志,2020,40(10):1228-1231.
[12]	Mclean D J, Diaz G D, Farhan H N, et al. Dose-dependent association between intermediate-acting neuromuscular-blocking agents and postoperative respiratory complications[J]. Anesthesiology,2015,122(6):1201-1213.
[13]	贾茜茜,韩彬,王军,等.无肌松喉罩静脉麻醉在支气管镜检查中的应用[J].中国内镜杂志,2018,24(9):39-43
[14]	Yan W, Xiong Y, Yao Y,et al. Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeated cesarean section under epidural anesthesia, a prospective, randomized study[J].BMC Anesthesiol,2019,19(1):243.
[15]	苏丽明,申岱,刘建. 心率变异性分析在瑞芬太尼对无肌松气管插管中自主神经活动性的影响中的应用[J].山东医药,2020,60(10):13-17.
[16]	董林林,王国年.星状神经节阻滞治疗创伤后应激障碍应用进展[J].国际麻醉学与复苏杂志,2015,36(2):174-7.
[17]	Baene B,Plaud B,Dilly M P,et al.Residual paralysis in the PACU after a single intubating dose of nondepolarizing muscle relaxant with an intermediate duration of action[J]. Anesthesiology,2003,98(5):1042-1048.
[18]	Berg H,Roed J, Viby M J,et al. Residual neuromuscular block is a risk factor for postoperative pulmonary complications [J].Acta Anaesthesiol Scand,1997,41(9):1095-1103.
[19]	Murphy G S, Szokol J W, Marymont J H,et al. Residual neuromuscular blockade and critical respiratory events in the postanesthesia care unit[J]. Anesth Analg,2008,107(1):130-137
[20]	白玉赫,罗爱伦,黄宇光,等.单次插管剂量罗库溴铵残余肌松作用对妇科腹腔镜术后早期肺功能的影响[J].中国医学科学院报,2010,32(1):103-107.
[21]	Eikermann M, Groeben H, Bunten B,et al.Fade of pulmonary function during residual neuromuscular blockade[J]. Chest,2005,127(5):1703-1709.
[22]	李政,成双,李凯,等.无肌松药气管插管的进展[J].吉林大学学报(医学版),2019,45(2):465-468.