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随着干预性支气管镜检查的可知觉:分析与止痛可知觉指数

Kuang-Cheng Chan¹, Chih-Jun Lai¹, Ching-Kai Lin²

¹Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.

Asian journal of anesthesiology

|September 25, 2025

概括

局部麻醉 (TA) 在干预性支气管镜检查 (IB) 期间有效地控制恶感. 这项研究表明,TA减少了患者的反应,有助于麻醉管理,使手术更顺利.

科学领域:

麻醉学麻醉学
呼吸系统医学呼吸系统医学
疼痛管理疼痛管理

背景情况:

干预性支气管镜 (IB) 麻醉具有挑战性,因为患者的反应不可预测,如咳和脱.
在IB手术中, nociception 和局部麻醉 (TA) 的作用仍未得到充分研究.
了解 nociception 时间和 TA 的影响对于优化 IB 麻醉至关重要.

研究的目的:

在IB期间映射出 nociception 的时间和强度.
为了确定TA的起作用时间.
为了澄清TA在IB期间阻断 nociception 的有效性.

主要方法:

在82名患者中利用了镇痛感知指数 (ANI) 和平均动脉血压 (MBP).
在IB期间,监测患者在双光谱指数 (BIS) 控制的静脉内麻醉中.
在麻醉诱导,iGel插入,纤维光学支气管镜 (FOB) 插入和TA (西洛卡因) 应用时采用喷雾即用 (SAYGO) 方法收集的数据.

主要成果:

插入iGel显著降低了ANI (P < 0.001).
赛戈方法显著降低了ANI (P<0.001),该ANI在5分钟内恢复到基线.
平均动脉血压变化反映了ANI趋势; BIS和ANI之间没有发现相关性.

结论:

ANI 提供了关于 nociception 的宝贵见解,有助于 IB 的麻醉管理.
在IB手术过程中,TA有效地阻断了知觉.
建议在FOB插入前使用短效麻醉剂,以增强TA的效果并确保流的程序.

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