Lee M C, Absalom A R, Menon D K, Smith H L
University Department of Anaesthesia, Addenbrooke's NHS Trust, Cambridge, UK.
Anaesthesia. 2006 Jan;61(1):32-5. doi: 10.1111/j.1365-2044.2005.04471.x.
We assessed the use of intravenous remifentanil for the insertion of the laryngeal mask airway in 10 healthy awake volunteers, a technique primarily developed to facilitate functional magnetic resonance imaging studies of anaesthesia. Each volunteer received 200 microg glycopyrronium intravenously. Topical airway anaesthesia was effected by 4 ml nebulised lidocaine 4%, followed by 12 sprays of lidocaine 10%. Remifentanil was subsequently infused to achieve an initial target effect-site concentration of 2 ng.ml(-1); increments of 1 ng.ml(-1) were allowed with the maximum effect-site concentration limited to 6 ng.ml(-1). Insertion of the laryngeal mask airway was successful on the first attempt in all cases. The median (IQR [range]) target effect-site remifentanil concentration at insertion was 2.5 (2-3 [2-4]) ng.ml(-1). All volunteers were co-operative during the procedure and only one reported discomfort. Sore throat was a complication in all volunteers. We conclude that the technique allows successful insertion of the laryngeal mask airway in healthy awake volunteers under conditions that were safe and reproducible.
我们评估了静脉注射瑞芬太尼用于10名健康清醒志愿者插入喉罩气道的情况，该技术主要是为便于进行麻醉功能磁共振成像研究而开发的。每名志愿者静脉注射200微克格隆溴铵。通过雾化4%的利多卡因4毫升进行气道表面麻醉，随后喷入10%的利多卡因12喷。随后输注瑞芬太尼，使初始效应室浓度达到2纳克·毫升⁻¹；允许以1纳克·毫升⁻¹的增量增加，最大效应室浓度限制为6纳克·毫升⁻¹。所有病例首次尝试插入喉罩气道均成功。插入时瑞芬太尼效应室目标浓度的中位数（四分位间距[范围]）为2.5（2 - 3[2 - 4]）纳克·毫升⁻¹。所有志愿者在操作过程中均配合良好，只有一人报告有不适。所有志愿者均出现咽喉疼痛这一并发症。我们得出结论，该技术能够在安全且可重复的条件下，使健康清醒志愿者成功插入喉罩气道。
