关键词: 磷丙泊酚二钠, 超声引导下经支气管针吸活检术, 全身麻醉, 血流动力学

Abstract:

Objective To compare the hemodynamic changes and safety of fospropofol disodium and propofol during anesthesia induction in patients undergoing painless endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-TBNA）. Methods Sixty-eight patients scheduled for elective painless EBUS-TBNA， aged 40 ~ 65 years with ASA physical status Ⅰ - Ⅲ， were enrolled and randomly allocated （1∶1） to the fospropofol disodium group （F group， n = 34） or the propofol group （P group， n = 34） using a random number table. Anesthesia induction was performed with intravenous sufentanil （0.3 μg/kg）， followed by fospropofol disodium （12.5 mg/kg， F group） or propofol （2 mg/kg， P group） within 1 min. Rocuronium （0.6 mg/kg） was administered when the modified observer′s assessment of alertness/sedation scale （MOAA/S） score was ied observerd observerhen the modified observerd transbronchial needle aventilation. Mean arterial pressure （MAP）， heart rate （HR）， and bispectral index （BIS） were recorded at six time points： entering the operating room （T₀）， 1 min after induction （T₁）， immediately after laryngeal mask insertion （T₂）， bronchoscope passing through the glottis （T₃）， at the end of the EBUS-TBNA procedure （T₄）， and 3 min after extubation （T₅）. Intraoperative sedative and vasoactive drug consumption， sedation success rate， and incidence of adverse events were also assessed. Results Compared with the P group， the F group showed significantly higher MAP at T₁ and T₄ （P < 0.05）， a lower incidence of intraoperative hypotension （P < 0.05）， and reduced total ephedrine use （P < 0.05）. The F group had a significantly longer time to loss of consciousness （P < 0.05）， higher incidence of paresthesia （P < 0.05）， and lower incidence of injection pain （P < 0.01）. No significant differences were observed between groups in BIS，HR， sedation success rate， recovery time， or incidence of bradycardia and tachycardia （all P > 0.05）. Conclusion Compared with propofol， fospropofol disodium provides more stable hemodynamics during general anesthesia for EBUS-TBNA， significantly reducing the incidence of hypotension and injection pain； however， it has a longer induction time and is associated with risks such as skin pruritus and paresthesia.

Key words: fospropofol disodium, endobronchial ultrasound-guided transbronchial needle aspiration, general anesthesia, hemodynamics