关键词: 支气管镜, 右美托咪定, 芬太尼, 丙泊酚

Abstract: ［Abstract］ Objective〖HTSS〗〓To investigate the effect of dexmedetomidine or propofol combined with fentanyl in patients with fiberoptic bronchoscopy.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty patients undergoing selective general anesthesia fiberoptic bronchoscopy were randomly divided into two groups(n=30 each): dexmedetomidine group(D group) and propofol group(P group). Before induction of anesthesia, patients in both groups received an infusion dose of 1 μg/kg fentanyl. Thereafter, in group D, a loading dose of dexmedetomidine 1 μg/kg was injected at 15 min before induction of anesthesia, followed by infusion at 0.4 μg·kg-1·h-1 until the end of fiberoptic bronchoscopy. In group P, the initial effectsite target for propofol concentration was 4 mg/L. Subsequently, the concentration of propofol was maintained at a level between 2 and 3 mg/L. mean arterial pressure(MAP), heart rate(HR), oxygen saturation(SpO2) and Observer Assessment of Alertness/Sedation(OAA/S） score were recorded at baseline(T0), immediately after induction(T1), when the tip of fiberoptic bronchoscopy reached the glottis(T2)and carina(T3), at the end of bronchoscopy(T4). The duration of bronchoscopy, emergence time, anesthesia effect, adverse cardiovascular events and side effects such as hyoxemia, nausea and vomiting, regurgitation and aspiration were recorded.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The OAA/S score of two groups were obviously decreased at T1 time point, increased gradually and then decreased again. The difference in OAA/S score time dissimilarity in the two groups at the groups and time points were statistically significant(P＜005). However, there was no significant difference in the interblock and interaction between group and time(P＞005). The MAP， HR and SpO2 of two groups were gradually lower at T1 -T3 time point, and then gradually incredsed at T4 time point. In MAP， HR and SpO2,interblock、time dissimilarity and interaction of interblock with time dissimilarity of the two groups had statistically significant difference. Compared with group P, the recover time significantly longer〖JP2〗(P＜005), the incidence hypoxemia was significantly lower(P＜005). There was no 〖JP〗significantly difference in anesthesia effect and the duration bronchofiberscopy. No patients developed side effects such as nausea and vomiting, regurgitation and aspiration in both groups.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Dexmedetomidine combined with fentanyl is an ideal method for sedative analgesia painless bronchofibroscopy with more slighter cardiovascular response and less side effects. 

Key words: bronchoscopes, dexmedetomidine, fentanyl, propofol