Pang L, Zhuang Y Y, Dong S, Ma H C, Ma H S, Wang Y F
Department of Gastroenterology, The Second Hospital of Jilin University, Changchun, China.
Niger J Clin Pract. 2014 Jul-Aug;17(4):456-61. doi: 10.4103/1119-3077.134038.
The objective of the following study is to examine the effectiveness and safety of suspension laryngoscopy under intubation with propofol and remifentanil alone for vocal fold nodule (VFN) excision.
A total of 40 patients were equally and randomly assigned to elective VFN excision using suspension laryngoscopy under intubation with propofol and remifentanil alone (Group A) or with supplementary cisatracurium (Group B).
Intubation time was significantly longer in Group A than in Group B (300.0 ± 30.0 s vs. 265.2 ± 38.7 s, P = 0.003). The two groups showed similar Cormack-Lehane classifications, intubation conditions and ease of suspension laryngoscopy. Both groups showed favorable cardiopulmonary safety profiles. Post-anesthesia recovery was significantly more rapid in Group A than in Group B, in terms of times to spontaneous breathing return (7.2 ± 1.4 min vs. 10.9 ± 1.6 min, P < 0.001), consciousness return (7.4 ± 1.5 min vs. 12.3 ± 1.8 min, P < 0.001), removal of tracheal intubation (8.1 ± 1.5 min vs. 13.2 ± 1.7 min, P < 0.001) and operating room discharge (12.7 ± 1.4 min vs. 22.1 ± 1.3 min, P < 0.001).
Use of propofol and remifentanil alone provides favorable intubation and anesthesia conditions for suspension laryngoscopic VFN excision and accelerates post-anesthesia recovery.
以下研究的目的是检验单独使用丙泊酚和瑞芬太尼行插管全身麻醉下支撑喉镜手术切除声带小结（VFN）的有效性和安全性。
总共40例患者被平均随机分配，分别接受单独使用丙泊酚和瑞芬太尼行插管全身麻醉下支撑喉镜手术切除声带小结（A组），或联合使用顺式阿曲库铵（B组）。
A组的插管时间显著长于B组（300.0 ± 30.0秒 vs. 265.2 ± 38.7秒，P = 0.003）。两组的Cormack-Lehane分级、插管条件及支撑喉镜操作的难易程度相似。两组的心肺安全性均良好。在自主呼吸恢复时间（7.2 ± 1.4分钟 vs. 10.9 ± 1.6分钟，P < 0.001）、意识恢复时间（7.4 ± 1.5分钟 vs. 12.3 ± 1.8分钟，P < 0.001）、气管插管拔除时间（8.1 ± 1.5分钟 vs. 13.2 ± 1.7分钟，P < 0.001）及出手术室时间（12.7 ± 1.4分钟 vs. 22.1 ± 1.3分钟，P < 0.001）方面，A组的麻醉后恢复明显快于B组。
单独使用丙泊酚和瑞芬太尼可为支撑喉镜下声带小结切除术提供良好的插管及麻醉条件，并加速麻醉后恢复。
