Clinical Application Of Oxycodone Compounded With Dexmedetomidine In Painless Fiber Bronchoscopy

Objective : With the population aging and the environment deterioration,the incidence of respiratory diseases is on the rise every year.Fiberoptic bronchoscopy(FB)is one of the most common diagnostic methods for clinical respiratory diseases,which includes brushing,biopsy,suction of lavage fluid,selective bronchial infusion lung therapy,sputum suction and lavage and so on.We find that most of the patients who underwent this examination are elderly people with lung disease.They have complex conditions accompanied other systemic diseases.Their tolerance to narcotic drugs is poor,and the range of safe medication is narrow.Besides,some of the patients have low blood oxygen saturation and general anesthetic method and the narcotic medicaments have the varying degree of respiration inhibition and result in the hypoxemia.How to anesthesia these patients is challenging to clinical anesthesia.The core issue is to ensure the safety and reduce the occurrence of complications.Facing these problems,we look over a large number of domestic and foreign researches and reports,and compared the advantages and disadvantages of various anesthetic methods and drug compatibility.We decide to observe the clinical application oxycodone compounded with dexmedetomidine in painless fiber bronchoscopy under sober sedation anesthesia.In the anesthesia,patients not only have no tension and anxiety,but also cope with intraoperative treatment.The compatibility of hydroxylamine hydrochloride with the dexmedetomidine has a little effect on the respiratory system,but also has the advantages of less postoperative adverse reactions,especially for the elderly patients have little influence to the physiological function.The research evaluated clinical effect and safety of oxycodone compounded with dexmedetomidine in painless fiber bronchoscopy.Substance:60 outpatients were selected for painless FB examination from April2016 to December 2017.They were randomly divided into hydroxylamine hydrochloride Group and Sufentanil Group.There was no statistical difference between both group with 30 cases(age:21-77,weight: 45-80kg).American Society of Anesthesia Physicians(ASA)grading standards were consulted with II-III Grade.All the patients were built peripheral venous pathways.The patients in oxycodone group were administered with 0.1mg/kg oxycodone and 0.5-0.6ug/kg dexmedetomidin.And sufentanil group were administered with 0.06-0.1ug/kg sufentanil and0.5-0.6 ug/ kg dexmedetomidin.And then DEX was pump injected in the 10 min,followed by a film puncture under the local tracheal anesthesia of 1.5ml 1% of tetracaine.After about 5min,FB check was begun.Heart rate(HR),oxygen saturation(SPO2),systolic blood pressure(SBP)and diastolic blood pressure(DBP)were recorded in six times,which wasresting state(T0),before the mirror(T1),immediately after glottis(T2),5min after glottis(T3),10 min after glottis(T4),and 2min after the mirror(T5).The levels of tolerable anesthesia and adverse reactions were recorded.Furthermore,the anesthetic effect with alertness/sedation(OAA/S)score and patient satisfaction were evaluation indicators.Methods: SPSS19.0 statistics software was applied.The measurement data was indicated by (?)±s,the T test was compared between the two groups adopts.Single factor variance analysis was used in group comparison,and card square test was used to compare counting data.The difference is statistical difference when p<0.05.Results: The general data of the two groups were compared with no statistical difference(p>0.05),and there was no statistical difference with the HR,SPO2,SBP and DBP of T0(p>0.05).So the two groups were comparable.Compared with sufentani group at T1-T5,oxycodone group had higher SPO2(P<0.05,P<0.01)and less adverse reactions(P<0.05).They had no statistical difference in the anesthetic effect and OAA/S score(P>0.05).In terms of satisfaction and acceptance of repeated examination,oxycodone group was significantly better than sufentanil group,and the difference was statistically significant(P<0.05).Conclusions: It is safety and effective that oxycodone compounded with dexmedetomidine is used in painless fiber bronchoscopy.In all the operation,the patients have smooth vital signs,low adverse reactions,full oxygen supply,and good cooperation ability.