Tan Hong-ying, Cao Long-hui, Huang Wan, Zhong Zhong-jiang, Lin Wen-qian, Zeng Wei-an
Department of Anesthesiology, Sun Yat-sen University Cancer Center/State Key Laboratory of Oncology in South China, Guangzhou 510060, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 Aug;30(8):1857-9.
To compare the effect and hemodynamics of sevoflurane(SEV) and propofol (PRO) in combined anesthesia induction with remifentanil for tracheal intubation fibreoptic bronchoscope (FOB).
Twenty-four patients without difficult airway undergoing elective surgery with tracheal intubation general anesthesia were randomly divided into SEV and PRO group. FOB intubation was performed with sevoflurane or propofol administration combined with remifentanil induction. Blood pressure (BP), heart rate (HR), SPO2 and Narcotrend index (NI) were monitored to evaluate the anesthetic depth during the induction. The time to loss of consciousness (LOC), intubation time, intubation score, anesthetic dosage and adverse effects were recorded.
No significant difference was found between the two groups in the time to LOC, intubation time, intubation score, remifentanil dosage. Intubation was performed successfully in both groups. BP and HR of both groups decreased after the induction and did not increase after the intubation, with variation within the normal range. No significant difference in BP and HR was found between the two groups. NI of both groups decreased after the induction and during intubation. NI of SEV group 2 min after intubation was higher than that of PRO group. There was no significant difference in NI between the two groups at the other time points. No significant adverse effects or recall of the intubation procedure were reported.
Anesthesia induction FOB intubation with sevoflurane and propofol, both in combination with remifentanil, can be applied in surgical patients without contraindications to general anesthesia, and both methods can provide fast induction and good intubation condition with stable hemodynamics.
比较七氟醚（SEV）与丙泊酚（PRO）在与瑞芬太尼联合用于纤维支气管镜引导气管插管全身麻醉诱导中的效果及血流动力学变化。
将24例拟行择期手术、无困难气道且需气管插管全身麻醉的患者随机分为SEV组和PRO组。采用七氟醚或丙泊酚联合瑞芬太尼诱导进行纤维支气管镜引导下气管插管。监测诱导过程中的血压（BP）、心率（HR）、脉搏血氧饱和度（SPO2）及脑电双频指数（NI）以评估麻醉深度。记录意识消失时间（LOC）、插管时间、插管评分、麻醉用药量及不良反应。
两组在LOC时间、插管时间、插管评分、瑞芬太尼用量方面差异无统计学意义。两组均成功完成插管。诱导后两组BP、HR均下降，插管后未上升，波动在正常范围内。两组BP、HR差异无统计学意义。两组诱导后及插管过程中NI均下降。插管后2分钟SEV组NI高于PRO组。其他时间点两组NI差异无统计学意义。未报道明显不良反应及对插管过程存在回忆。
七氟醚和丙泊酚联合瑞芬太尼用于纤维支气管镜引导气管插管全身麻醉诱导，可应用于无全身麻醉禁忌证的手术患者，两种方法均可实现快速诱导，提供良好的插管条件，且血流动力学稳定。
