Nasseri Karim
Department of Anesthesiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Adv Biomed Res. 2017 Sep 21;6:119. doi: 10.4103/abr.abr_265_16. eCollection 2017.
The amount of sedation and muscle relaxation of the jaw may have an impact on complications caused by laryngeal mask airway (LMA). The aim of this study is to evaluate the effect of low-dose Atracurium on conditions of insertion, complications, and hemodynamic responses to LMA insertion following induction of anesthesia with propofol, in patients undergoing cataract surgery.
In this double-blind randomized clinical trial study, 60 patients were randomly divided into two groups. Initially, the patients in the study group received 0.15 mg/kg intravenous injection of atracurium, and the patients in the control group received 2 ml of intravenous injection of normal saline, after which anesthesia in both groups were induced with midazolam, fentanyl, lidocaine, and propofol. The amount of jaw relaxation, ease of insertion, and the time needed for insertion, hemodynamic responses and complications of LMA insertion were evaluated.
Jaw relaxation and ease of LMA insertion in the study group was significantly better than that of the control group ( = 0.02). Average time needed for LMA placement in the study group (5/06 ± 0.52 second) was significantly lower than the control group (5/76 ± 0.67 second) ( = 0.001). Hemodynamic response to LMA insertion was similar in both groups. Sore throat at recovery and 24 h after surgery in the control group was significantly higher than that of the study group (3/30 vs. 10/30) ( = 0.01).
Using low doses of atracurium decreases the time needed for LMA insertion and sore throat after the operation. Atracurium also increases jaw relaxation and facilitates the placement of LMA.
下颌的镇静程度和肌肉松弛情况可能会对喉罩气道（LMA）引发的并发症产生影响。本研究旨在评估小剂量阿曲库铵对白内障手术患者在丙泊酚诱导麻醉后LMA插入情况、并发症及血流动力学反应的影响。
在这项双盲随机临床试验研究中，60例患者被随机分为两组。最初，研究组患者静脉注射0.15mg/kg阿曲库铵，对照组患者静脉注射2ml生理盐水，之后两组均用咪达唑仑、芬太尼、利多卡因和丙泊酚诱导麻醉。评估下颌松弛程度、插入的难易程度、插入所需时间、血流动力学反应以及LMA插入的并发症。
研究组的下颌松弛程度和LMA插入的难易程度明显优于对照组（P = 0.02）。研究组LMA放置的平均时间（5.06±0.52秒）明显低于对照组（5.76±0.67秒）（P = 0.001）。两组对LMA插入的血流动力学反应相似。对照组术后恢复时及术后24小时的咽痛发生率明显高于研究组（30例中有3例 vs. 30例中有10例）（P = 0.01）。
使用小剂量阿曲库铵可减少LMA插入所需时间以及术后咽痛。阿曲库铵还可增加下颌松弛度并便于LMA放置。
