与芬太尼-丙泊酚联合使用相比，阿芬太尼-丙泊酚联合使用可改善喉罩置入情况。

Co-administration of alfentanil-propofol improves laryngeal mask airway insertion compared to fentanyl-propofol.

作者信息

Hui Jacqueline K L, Critchley Lester A H, Karmakar Manoj K, Lam Patrick K K

机构信息

Department of Anaesthesia Intensive Care, The Chinese University of Hong Kong Prince, of Wales Hospital, Shatin, New Territories, Hong Kong, Peoples Republic of China.

出版信息

Can J Anaesth. 2002 May;49(5):508-12. doi: 10.1007/BF03017932.

DOI:10.1007/BF03017932

PMID:11983670

Abstract

PURPOSE

Insertion of the laryngeal mask airway (LMA) requires sufficient depth of anesthesia to relax the jaw and obtund airway reflexes. Recent studies suggest that the short-acting opioid alfentanil provides the best insertion conditions. We therefore compared the insertion conditions following co-administration of alfentanil-propofol with more commonly used fentanyl-propofol.

METHODS

One hundred forty ASA I or II patients, age 18-81 yr, requiring minor surgery were recruited. They were randomized to receive either alfentanil (10 microg x kg(-1); n = 73) or fentanyl (1 microg x kg(-1); n = 67) with propofol (2.5 mg x kg(-1)) 90 sec prior to LMA (size 3 or 4) insertion. A six variable (mouth opening, ease of insertion, swallowing, coughing, movement and laryngospasm) three-point (nil / partial / total) score was used to assess insertion conditions. Duration of post-insertion apnea was recorded. Insertion conditions were compared using Chi-square for trends.

RESULTS

The two groups were demographically similar. Mouth opening and ease of insertion were not improved with alfentanil co-administration. Alfentanil-propofol reduced the incidence of swallowing, gagging, movement and laryngospasm (P < 0.05), with 29% (alfentanil) compared to 45% (fentanyl) of patients responding (P = 0.05) to LMA insertion. Apnea [mean (SD)] following alfentanil lasted 154 (139) sec compared to 82 (61) sec following fentanyl (P = 0.001).

CONCLUSION

Co-administration of alfentanil-propofol provided better insertion conditions than fentanyl-propofol, though apnea was prolonged by 72 sec.

摘要

目的

插入喉罩气道（LMA）需要足够的麻醉深度以放松下颌并抑制气道反射。近期研究表明，短效阿片类药物阿芬太尼能提供最佳的插入条件。因此，我们比较了阿芬太尼 - 丙泊酚联合用药与更常用的芬太尼 - 丙泊酚联合用药后的插入条件。

方法

招募了140例年龄在18 - 81岁、需要进行小手术的美国麻醉医师协会（ASA）I或II级患者。在插入LMA（3号或4号）前90秒，他们被随机分为两组，分别接受阿芬太尼（10微克/千克；n = 73）或芬太尼（1微克/千克；n = 67）与丙泊酚（2.5毫克/千克）。使用六点变量（张口度、插入难易程度、吞咽、咳嗽、运动和喉痉挛）三分制（无/部分/完全）评分来评估插入条件。记录插入后呼吸暂停的持续时间。使用卡方检验趋势来比较插入条件。

结果

两组在人口统计学上相似。联合使用阿芬太尼并未改善张口度和插入的难易程度。阿芬太尼 - 丙泊酚降低了吞咽、呛咳、运动和喉痉挛的发生率（P < 0.05），对LMA插入有反应的患者中，阿芬太尼组为29%，芬太尼组为45%（P = 0.05）。阿芬太尼后呼吸暂停的平均（标准差）持续时间为154（139）秒，而芬太尼后为82（61）秒（P = 0.001）。