Application Of Different Doses Of Hydromorphone-assisted Propofol Target Controlled Infusion Combined With Laryngeal Mask In Fiberoptic Bronchoscopy

Objective: To observe the application of different doses of hydromorphone(HM)assisted propofol target-controlled infusion combined with laryngeal mask airway(LMA)in fiberoptic bronchoscopy(FB).Methods: Sixty patients who underwent FB in our hospital from December 2018 to November 2019 were randomly divided into group A(hydromorphone 0.005 mg/kg),Group B(hydromorphone 0.01 mg/kg),Group C(hydromorphone 0.015 mg/kg).Observe the mean arterial pressure before(T0),1 min(T1)after induction,3 min(T2)after induction,(T3),intraoperative(T4),and awake(T5).Mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),Oxygen saturation(Sp O2);observed FB time,anesthesia recovery time,60 min postoperative visual analogue scale(VAS);The incidence of hypoxemia,cough,nausea and vomiting,and pharyngeal discomfortResults: The heart rate and blood pressure in each group decreased significantly compared with the T0 T2 the group in each period,(p<0.05),and the heart rate increased significantly in the T3、T4 group(0.05).T1、T2、T4 heart rate decreased significantly in B group(p<0.05).The heart rate T1~T5 C group decreased significantly(p T1~T5 0.05).the T3 blood pressure in A group was significantly elevated(p<0.05).T1、T2 blood pressure decreased significantly in B group(p<0.05).C Group T1~T 4 A significant decrease,statistically significant(P<0.05).There was no significant change in the Sp O2 of the patients in the three groups(P>0.05).The cough body movement in B、C group was significantly lower than that in A group(P <0.05).The examination time of B、C group was significantly shorter than that of A group,and the difference was statistically significant(P<0.05).The recovery time of B group and A group was significantly shorter than that of C group(P<0.05).The VAS score of B、C group was significantly lower than that of A group(P <0.05).Comfort satisfaction was higher in B group A、C group,the difference was statistically significant(P<0.05).All three groups had no hypoxemia and vomiting,and the incidence of nausea and pharynx discomfort was not statistically significant(P>0.05).Conclusion: Hydromorphone(0.01 mg/kg)combined with propofol target-controlled infusion combined with laryngeal mask ventilation has a good effect in fiberoptic bronchoscopy,which can effectively inhibit the intraoperative stress response caused by FB and maintain hemodynamic stability.It can shorten the time of anesthesia recovery,high patient satisfaction,excellent postoperative analgesic effect,low incidence of adverse reactions,good safety,and high clinical application value.