Observation of the Application Effect and Safety of Different Doses of Fentanyl Combined with Dex in Bronchoscopy Anesthesia

WANG Xiaoqun; LI Dongxue; NI Wenjing

doi:10.3639/j.issn.2095-3097.2024.11.056

Abstract：Objective To explore the application effect and safety of different doses of fentanyl combined with dex-medetomidine(Dex)in bronchoscopy anesthesia.Methods 150 patients who underwent bronchial examination in Tangshan Workers'Hospital from April 2023 to June 2024 were selected,the patients were divided into Group A,Group B,and Group C using a random number table method,with 50 cases in each group.Group Group A received slow intravenous injection of fentanyl at a dose of 10 μg/kg for more than 30 seconds.Two minutes later,propofol was administered intravenously at a dose of 1mg/kg,followed by continuous infusion of dexmedetomidine at a dose range of(0.4-0.8)μg/(kg·h).Group B received slow intravenous injection of fentanyl at a dose of 5 μg/kg,with Dex and propofol used in the same manner as Group A.Group C only received continuous infusion of Dex and propofol,with the same dosage and administration as Group A.The infusion rate was adjusted according to the patient's condition monitored during surgery.Group B received slow intravenous injection of fentan-yl at a dose of 5 μg/kg,with Dex and propofol used in the same manner as Group A.Group C received Dex and propofol were continuously infused using the same method as Group A.The clinical data,hemodynamic in-dicators at different time points,evaluation of anesthesia effectiveness,dosage of anesthetic drugs,operation time,time to restore spontaneous breathing,time to remove laryngeal mask,time to leave the anesthesia monitoring treatment room,bronchoscopy passing through the glottis score,bronchoscopy passing through the prominence score,and differences in adverse reactions among different groups were observed and compared.Results The mean arterial pressure(MAP)and heart rate(HR)of group A were higher than those of group B and C at the time of bronchoscopy passing through the glottis(T1),bronchoscopy passing through the protuberance(T2),end of examination(T3),removal of laryngeal mask(T4),and 5 minutes after removal of laryngeal mask(T5)(P<0.05).There was no statistically significant difference in blood ox-ygen saturation(SpO2)and bispectral Index(BIS)between each group in T0,T1,T2,T3,T4 and T5(P>0.05).The proportion of Grade I anesthesia efficacy evaluation in Group A and Group B was higher than that in Group C(P<0.05).The dosage of propo-fol in Group A was significantly lower than that in Group B and Group C(P<0.05).The operation time,recovery of spontaneous breathing time,removal of laryngeal mask,and time to leave the anesthesia monitoring treatment room in Group A were faster than those in Group B and Group C(P<0.05).The scores for bronchoscopy passing through the glottis and prominence in Group A were lower than those in Group B and Group C(P<0.05).The total incidence of adverse reactions in Group A and Group B was significantly lower than that in Group C(P<0.05).Conclusion The combination of 10 μg/kg fentanyl and Dex has good application value in bronchoscopy anesthesia,with stable hemodynamics,fast postoperative recovery,and few adverse reactions in patients.