Evaluation Of The Effect And Security On Fentanil-Propofol In Bronchofibroscopy

Objective: The Research of Effect and Security and the best dose of Fentanyl combined with Propofolum in Conscius Sedation BronchofibroscopyMethods:1. 191 patients were divided into Fentanyl combined with Propolum group(Ⅰgroup 100) and control group(Ⅱroutine bronchofibroscopy group 91) randomly. To observe the unwell of patients , HR Spo2 SBP DBP and plasm level of Noradrenaline before, during after examination .Meanwhile the survey were carried out with questionnaire after examination.2. 420 patients were divided into three group(140/group),Ⅰgroup(Fentanyl 0.5μg/kg intravenous injection),Ⅱgroup(Fentanyl 1.0μg/kg intravenous injection) andⅢgroup (Fentanyl 1.5μg/kg intravenous injection ),then intravenous inject Propofolum slowly, bronchofibroscopy were carried out when eyelashes and corneal reflex disappeared . To observe and record the unwell of patients , the time of bronchofibroscopy, the onset time of junk,the time of Palinesthesia and consciousness, HR Spo2 SBP DBP before, during after examination and the dose of Propofolum .Result: 1. There was lower rate of unwell and shorter examination time inⅠgroup than inⅡgroup (P<0.05).100% patients had no complaints and would like to receive repeated examination(P<0.01). HR Spo2 SBP DBP decreased temporally for majority within normal limits , decreased lower than normal limits for minority and revert after routine treatment. Plasm level of Noradrenaline of two group after examination increased significantly(P<0.01),and plasm level of Noradrenaline of control group increased more significantly(P<0.01).Patients≥60 years old ofⅠgroup had more stable hemodynamics thanⅡgroup,the BP of control group increased more significantly(P<0.01), combined intravenous anesthesia was feasible for patients with pulmonary Incompetence.2. There was higher rate of unwell ,part of patients need more Propofolum ( P<0.01 ) , and longer examination time (P<0.05) inⅠgroup than inⅡandⅢgroup (P<0.05). Spo2 inⅢgroup decreased more significantly than Spo2 inⅠgroup andⅡgroup(P<0.05),Spo2 inⅠgroup andⅡgroup was normal mostly, Spo2 inⅠgroup was below 80%,and revert after treatment.Bp in three groups in examination decressed more significantly than before examination(P<0.01),but revert quickly after examination.Conclusion: Intravenous injection of 1.0μg/kg Fentanyl once combined with Propofolum in conscious sedation bronchofibroscopy was a safe,effective and desirable comparatively method.