目的 观察艾司氯胺酮联合丙泊酚麻醉用药方案在无痛支气管镜检查麻中的有效性及安全性。方法 选取2020年9月—2021年11月90例无痛支气管镜检查患者,采用前瞻性研究方法,按照1∶1比例纳入分组,观察组（45例）患者给予艾司氯胺酮联合丙泊酚麻醉方案,对照组（45例）患者采用舒芬太尼联合丙泊酚用药方法,对比两组在麻醉前（T0）、置无痛支气管前（T1）、支气管镜经过声门时（T2）、支气管镜抵达隆突时（T3）、纤维支气管镜取出时（T4）、苏醒时（T5）、检查结束30 min后（T6）MAP、HR值及麻醉安全性。结果 观察组T1、T2、T3时间段MAP波动范围低于对照组（P<0.05）;观察组T2、T3、T4、T6时间段HR波动范围低于对照组,差异有统计学意义（P<0.05）;观察组T3、T4时段内SpO₂值高于对照组（P<0.05）;观察组呛咳、麻醉苏醒时间、麻醉清醒时间均低于对照组（P<0.05）;观察组不良反应发生率为6.67%（3/45）,对照组为26.67%（12/45）,P<0.05。结论 与舒芬太尼相比较,艾司氯胺酮联合丙泊酚麻醉方案能够使血流动力学更加稳定,并发症明显减少。

Objective To observe the efficacy and safety of esketamine combined with propofol anesthesia in painless bronchoscopy. Methods The prospective study enrolled 90 patients with painless bronchoscopy from September 2020 to November 2021 and divided them into two groups according to the ratio of 1：1. The patients in the observation group （45 cases） were given esketamine combined with propofol anesthesia, and the patients in the control group （45 cases） were given sufentanil combined with propofol. The two groups were compared in terms of MAP, HR, and anesthesia safety before anesthesia （T0）, before painless bronchoscopy （T1）, when bronchoscope passes through glottis （T2）, when bronchoscope reaches carina （T3）, when fiberoptic bronchoscope is taken out （T4）, when the patient wakes up （T5）, and 30 min after examination （T6）. Results The fluctuation ranges of MAP at T1, T2, and T3 in the observation group were lower than those in the control group （P<0.05）. The fluctuation ranges of HR in the observation group at T2, T3, T4, and T6 were lower than those in the control group （P<0.05）. The SpO₂ values at T3 and T4 in the observation group were higher than those in the control group （P<0.05）. The incidence rate of cough, anesthesia awakening time, and anesthesia awareness time in the observation group were lower than those in the control group （P<0.05）. The incidence rate of adverse reactions was 6.67% （3/45） in the observation group and 26.67% （12/45） in the control group （P<0.05）. Conclusion Compared with sufentanil, the anesthesia scheme of esketamine combined with propofol can make hemodynamics more stable and reduce complications obviously.