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在不使用肌肉松弛剂的情况下,评估不同剂量丙泊酚的插管条件。

Evaluation of Intubating Conditions with Varying Doses of Propofol without Muscle Relaxants.

作者信息

Gore Mangesh S, Harnagale Kalpana D

机构信息

Resident, Dept. of Anesthesiology, Grant Medical College, Mumbai, India.

出版信息

J Anaesthesiol Clin Pharmacol. 2011 Jan;27(1):27-30.

PMID:21804701
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3146153/
Abstract

BACKGROUND

Since 1988 anaesthesiologist have proved that induction dose of propofol is sufficient to intubate patient without muscle relaxants. Propofol is unique in having property to suppress airway reflexes better than any other agent. Therefore study was undertaken to evaluate clinically acceptable intubating conditions with different doses of propofol without muscle relaxants.

PATIENTS AND METHODS

90 ASA grade I and II patients posted for elective surgery requiring general anesthesia divided randomly into group I (propofol 2 mg kg(-1)); group II (2.5 mg kg(-1)); groupIII (3mg kg(-1)). Premedication with inj.Glycopyrollate, inj.Ranitidine, Inj.Ondensetron; inj.Midazolam and inj.fentanyl was done. After waiting for 5 minutes, induction dose of propofol was given followed by inj.lignocaine 90 seconds prior to intubation. Intubating conditions were assessed and hemodynamic changes were recorded at various levels.

RESULTS

Ideal intubating conditions were obtained in 96.7%of patients in group II (2.5 mg kg(-1) propofol) and 100% in group III (3 mg kg(-1) propofol). We found that clinically acceptable intubating conditions can be achieved with 2.5 mg kg(-1) and 3 mg kg(-1) propofol without significant hemodynamic changes and 100% success can be obtained with 3 mg kg(-1) of propofol

CONCLUSION

Ideal intubating conditions without muscle relaxants can be achieved with propofol 3 mg kg(-1) with fentanyl 2 μg kg(-1) and lignocaine 1.5 mg kg(-1) without significant hemodynamic changes.

摘要

背景

自1988年以来,麻醉医生已证实丙泊酚的诱导剂量足以在不使用肌肉松弛剂的情况下为患者进行插管。丙泊酚的独特之处在于,它比任何其他药物都更能有效抑制气道反射。因此,本研究旨在评估在不使用肌肉松弛剂的情况下,不同剂量丙泊酚的临床可接受插管条件。

患者与方法

90例拟行择期手术、需要全身麻醉的ASA I级和II级患者,随机分为I组(丙泊酚2mg/kg)、II组(2.5mg/kg)、III组(3mg/kg)。给予格隆溴铵注射液、雷尼替丁注射液、昂丹司琼注射液、咪达唑仑注射液和芬太尼注射液进行术前用药。等待5分钟后,给予丙泊酚诱导剂量,在插管前90秒给予利多卡因注射液。评估插管条件,并记录不同水平的血流动力学变化。

结果

II组(丙泊酚2.5mg/kg)96.7%的患者和III组(丙泊酚3mg/kg)100%的患者获得了理想的插管条件。我们发现,2.5mg/kg和3mg/kg的丙泊酚可实现临床可接受的插管条件,且无明显血流动力学变化,3mg/kg的丙泊酚成功率可达100%。

结论

丙泊酚3mg/kg联合芬太尼2μg/kg和利多卡因1.5mg/kg可在不使用肌肉松弛剂的情况下获得理想的插管条件,且无明显血流动力学变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/3146153/98eae7e2f9db/JOACP-27-27-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/3146153/997e92debb7a/JOACP-27-27-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/3146153/cd85023d55d1/JOACP-27-27-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/3146153/d1890fee3164/JOACP-27-27-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/3146153/98eae7e2f9db/JOACP-27-27-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/3146153/997e92debb7a/JOACP-27-27-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/3146153/cd85023d55d1/JOACP-27-27-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/3146153/d1890fee3164/JOACP-27-27-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/3146153/98eae7e2f9db/JOACP-27-27-g006.jpg

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Muscle relaxation and increasing doses of propofol improve intubating conditions.肌肉松弛和逐渐增加剂量的丙泊酚可改善插管条件。
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A combination of alfentanil-lidocaine-propofol provides better intubating conditions than fentanyl-lidocaine-propofol in the absence of muscle relaxants.在没有肌肉松弛剂的情况下,阿芬太尼-利多卡因-丙泊酚联合使用比芬太尼-利多卡因-丙泊酚提供更好的插管条件。
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Propofol - not thiopental or etomidate - with remifentanil provides adequate intubating conditions in the absence of neuromuscular blockade.
比较三种不同追加剂量丙泊酚输注对择期手术全身麻醉期间插管条件和血流动力学变化的影响:一项随机、安慰剂对照、双盲临床试验。
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