Watanabe A, Saka H, Hasegawa Y, Ogasawara T, Shimokata K
First Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Apr;30(4):593-7.
Manipulation, premedication, and chemoprophylaxis for fiberoptic bronchoscopy vary among institutions. We analyzed the actual conditions by means of a questionnaire distributed to 29 institutions. With regard to premedication, a combination of atropine sulfate and sedatives, such as hydroxyzine hydrochloride, was the most common method. In cases with heart disease and elderly subjects, a lower dosage or omission of atropine was common. In cases with marked anxiety, narcotics were prescribed. Bronchofiberscopic examination was performed under local anesthesia at all institutions. Lidocaine 4% was used for anesthesia of the orolarynx, and 2% was used for the tracheobronchus. For prophylaxis of infection, 19 of 29 institutions prescribed antibiotics routinely or under certain circumstances. ECG was used in 14 institutions, and percutaneous oxygen monitoring in 5 institutions. It is concluded that the manipulation and premedication for fiberoptic bronchoscopy vary between institutions. It is necessary to determine more efficacious and safer methods for fiberoptic bronchoscopy.
各机构在纤维支气管镜检查的操作、术前用药和化学预防方面存在差异。我们通过向29个机构发放问卷的方式分析了实际情况。关于术前用药，硫酸阿托品与镇静剂（如盐酸羟嗪）联合使用是最常见的方法。对于患有心脏病的患者和老年患者，减少阿托品剂量或不使用阿托品的情况很常见。对于焦虑明显的患者，会开具麻醉药品。所有机构均在局部麻醉下进行支气管纤维镜检查。4%的利多卡因用于口喉麻醉，2%的利多卡因用于气管支气管麻醉。为预防感染，29个机构中有19个在常规情况下或特定情况下开具抗生素。14个机构使用心电图，5个机构使用经皮氧监测。结论是，各机构在纤维支气管镜检查的操作和术前用药方面存在差异。有必要确定更有效、更安全的纤维支气管镜检查方法。
