Cho Sung-Ae, Sung Tae-Yun, Cho Choon-Kyu, Jee Young Seok, Kang Po-Soon
Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Myunggok Medical Research Center, Konyang University College of Medicine, Daejeon, Korea.
Korean J Anesthesiol. 2018 Feb;71(1):22-29. doi: 10.4097/kjae.2018.71.1.22. Epub 2017 Jul 4.
Propofol is used for supraglottic airway device insertion, often with the i-gel. However, the propofol requirement for i-gel insertion has not been explored in paralyzed patients. This study was performed to explore hemodynamic changes and sedation level with different propofol doses in healthy paralyzed patients when the i-gel was inserted.
A total of 141 patients undergoing a urologic operation were randomly allocated to three groups depending on the propofol dose (1.5, 2, and 2.5 mg/kg; Groups P1.5, P2, and P2.5, respectively). After patients had been administered each propofol dose and rocuronium, the i-gel was inserted and changes in hemodynamic parameters and bispectral index were evaluated.
Group P2 showed a lower incidence of complications (17%) such as hemodynamic instability and inadequate sedation than Group P1.5 (55.3%, P < 0.001) or Group P2.5 (40.4%, P = 0.012). The incidence and dose of additional propofol increased in Group P1.5 (51%, median [range]; 20 [0-50]) compared with those in the other groups (0%, 0 [0-0] in Group P2 and 8.5%, 0 [0-50] in Group P2.5, all P < 0.001), and the incidence and dose of additional ephedrine were significantly higher in Group P2.5 (31.9%; 0 [0-20]) than in Group P1.5 (10.6%, P = 0.012; 0 [0-5], P = 0.007, respectively).
For the stable maintenance of hemodynamic parameters and proper sedation level during i-gel insertion, 2 mg/kg propofol has an advantage over 1.5 mg/kg or 2.5 mg/kg propofol in healthy paralyzed patients.
丙泊酚常用于声门上气道装置插入，常与i-gel一起使用。然而，在麻痹患者中，插入i-gel时丙泊酚的需求量尚未得到研究。本研究旨在探讨在健康麻痹患者插入i-gel时，不同丙泊酚剂量下的血流动力学变化和镇静水平。
总共141例接受泌尿外科手术的患者根据丙泊酚剂量（分别为1.5、2和2.5mg/kg；P1.5组、P2组和P2.5组）随机分为三组。在患者接受各丙泊酚剂量和罗库溴铵后，插入i-gel并评估血流动力学参数和脑电双频指数的变化。
与P1.5组（55.3%，P<0.001）或P2.5组（40.4%，P=0.012）相比，P2组血流动力学不稳定和镇静不足等并发症的发生率较低（17%）。与其他组相比，P1.5组额外丙泊酚的发生率和剂量增加（51%，中位数[范围]；20[0-50]）（P2组为0%，0[0-0]；P2.5组为8.5%，0[0-50]，所有P<0.001），P2.5组额外麻黄碱的发生率和剂量显著高于P1.5组（分别为31.9%；0[0-20]）（P1.5组为10.6%，P=0.012；0[0-5]，P=0.007）。
对于健康麻痹患者在插入i-gel期间稳定维持血流动力学参数和适当的镇静水平，2mg/kg丙泊酚比1.5mg/kg或2.5mg/kg丙泊酚具有优势。
