Kim Mi-Hyun, Oh Ah-Young, Han Sung-Hee, Kim Jin-Hee, Hwang Jung-Won, Jeon Young-Tae
Department of Anesthesiology and Pain Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
J Clin Anesth. 2015 Nov;27(7):595-601. doi: 10.1016/j.jclinane.2015.07.002. Epub 2015 Aug 25.
We compared magnesium sulphate with control, ketamine, rocuronium prime, and large-dose rocuronium (0.9 mg/kg) with regard to intubation conditions during rapid-sequence induction.
This is a prospective, randomized, double-blinded study.
The setting is at an operating room in a university-affiliated hospital.
One hundred ten patients scheduled for general anesthesia were randomly allocated to the following 5 groups in equal numbers.
The control and rocuronium 0.9 groups received rocuronium 0.6 and 0.9 mg/kg, respectively; the ketamine group was given 0.5 mg/kg ketamine 2 minutes before 0.6 mg/kg rocuronium; the rocuronium prime group received 0.06 mg/kg rocuronium 3 minutes before 0.54 mg/kg rocuronium; and the magnesium group received 50 mg/kg magnesium sulphate. Intubation was initiated 50 seconds after the rocuronium injection.
Intubating condition (primary outcome), rocuronium onset, rocuronium duration, train-of-four ratio upon intubation, and hemodynamic variables (secondary outcomes) were recorded.
The excellent intubating condition was more frequent in the magnesium group (P < .05). Onset of neuromuscular block was shorter in the magnesium group than in the control, ketamine, and rocuronium prime groups (P < .05). No difference in onset time was found between the magnesium and rocuronium 0.9 groups. Block duration was longest in the rocuronium 0.9 group. The train-of-four ratio on intubation was lowest in the rocuronium prime group. The only adverse event was a burning or heat sensation reported by 5 patients in the magnesium group.
Magnesium sulphate pretreatment was most likely to provide excellent intubating condition for rapid-sequence intubation compared with the control, ketamine pretreatment, rocuronium prime, and large-dose rocuronium. However, magnesium sulphate administration is associated with a burning or heat sensation.
我们比较了硫酸镁与对照组、氯胺酮、预注罗库溴铵以及大剂量罗库溴铵（0.9mg/kg）在快速顺序诱导插管时的插管条件。
这是一项前瞻性、随机、双盲研究。
在一所大学附属医院的手术室进行。
110例计划接受全身麻醉的患者被随机等分为以下5组。
对照组和罗库溴铵0.9mg/kg组分别给予罗库溴铵0.6mg/kg和0.9mg/kg；氯胺酮组在给予0.6mg/kg罗库溴铵前2分钟给予0.5mg/kg氯胺酮；预注罗库溴铵组在给予0.54mg/kg罗库溴铵前3分钟给予0.06mg/kg罗库溴铵；硫酸镁组给予50mg/kg硫酸镁。罗库溴铵注射后50秒开始插管。
记录插管条件（主要指标）、罗库溴铵起效时间、罗库溴铵作用持续时间、插管时的四个成串刺激比值以及血流动力学变量（次要指标）。
硫酸镁组优秀插管条件更为常见（P<.05）。硫酸镁组神经肌肉阻滞起效时间短于对照组、氯胺酮组和预注罗库溴铵组（P<.05）。硫酸镁组与罗库溴铵0.9mg/kg组的起效时间无差异。罗库溴铵0.9mg/kg组的阻滞持续时间最长。预注罗库溴铵组插管时的四个成串刺激比值最低。唯一的不良事件是硫酸镁组有5例患者报告有烧灼感或热感。
与对照组、氯胺酮预处理、预注罗库溴铵以及大剂量罗库溴铵相比，硫酸镁预处理最有可能为快速顺序插管提供优秀的插管条件。然而，给予硫酸镁会伴有烧灼感或热感。
