Comparison Of Effects Of Alfentanil And Remifentanil During Anesthesia For Patients In Electronic Flexible Bronchoscopy

Objective:By comparing the application of alfentanil and remifentanil in electronic flexible bronchoscopy,the incidence of sedation-related adverse events during operation and the satisfaction of patients after operation were compared,so as to provide a better sedation and analgesia scheme for patients.Methods:In the clinical randomized controlled trial,one huudred and fifity patients who underwent electronic flexible bronchoscopy were randomly divided into two groups:alfentanil group and remifentanil group.The vital signs(T0),1min(T1),5min(T2),10min(T3)and vital signs(T4)at the end of the operation were recorded.At the same time,the adverse reactions related to sedation during operation were recorded:the incidence of hypoxemia,the incidence of intraoperative cough,the incidence of postoperative nausea and vomiting,intraoperative hypotension and bradycardia,and the number of auxiliary ventilation strategies during operation: increasing oxygen flow,dragging the lower jaw and face mask ventilation,and recording the intraoperative dosage of propofol,operation time,eye opening time and time away from the room in the two groups.Record the content of norepinephrine in serum at different time points.The satisfaction scores of respiratory endoscopic doctors and patients were recorded.Results:1.There was no significant difference in age,sex,BMI and ASA grade between the two groups.2.There was no significant difference in operation time,eye opening time,time away from the room and propofol dosage between the two groups.(P > 0.05).3.There was significant difference in the incidence of hypoxemia between the two groups(P < 0.05).The incidence of hypoxia in the alfentanil group was lower than that in the remifentanil group,and the times of oxygen flow,mandibular dragging and mask ventilation were increased in the alfentanil group.The number of times in the remifentanil group was lower than that in the remifentanil group.4.There was significant difference in the incidence of postoperative complications between the two groups(P < 0.05).The incidence of postoperative nausea and vomiting with alfentanil was lower than that in remifentanil group.5.There was no significant difference in HR and MAP between the two groups(P > 0.05).However,within the groups,compared with T0,HR and MAP in remifentanil group and alfentanil group decreased at T1 time point,while HR and MAP increased gradually at T2-T4 time point.6.There was a significant difference in SpO2 between the two groups,and the decrease of SpO2 in remifentanil group was higher than that in alfentanil group at T1 time point.Intra-group comparison showed that compared with T0,SpO2 in remifentanil group and alfentanil group decreased at T1 time point,while SpO2 increased gradually at T2-T4 time point.7.There was no significant difference in the content of serum norepinephrine between the two groups at different time points(P>0.05).8.There was no significant difference in the satisfaction score of respiratory endoscope doctors on the examination process(P > 0.05).There was significant difference in the satisfaction score of the diagnosis and treatment process between the two groups(P < 0.05).The satisfaction in the alfentanil group was higher than that in the remifentanil group.Conclusion:1.The incidence of intraoperative hypoxemia in alfentanil group was lower than that in remifentanil group.2.The incidence of postoperative nausea and vomiting in alfentanil group was lower than that in remifentanil group.3.Compared with remifentanil group,alfentanil has less intraoperative and postoperative adverse reactions and higher satisfaction with the process of diagnosis and treatment,so it can be recommended for clinical use.