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比较三种不同剂量阿曲库铵在白内障超声乳化手术患者中辅助插入喉罩气道的安全性和有效性:一项随机临床试验。

Comparing the safety and efficacy of three different doses of atracurium in facilitating the insertion of laryngeal mask airway in patients undergoing phacoemulsification cataract surgery: A randomized clinical trial.

作者信息

Shetabi Hamidreza, Jebelli Elnaz, Shafa Amir

机构信息

Anesthesiology and Critical Care Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2020 Jul 27;9:28. doi: 10.4103/abr.abr_61_19. eCollection 2020.

Abstract

BACKGROUND

In this study, we aimed to evaluate the safety and efficacy of three different doses of atracurium on conditions of laryngeal mask airway (LMA) insertion, first-try success rate, and possible complications.

MATERIALS AND METHODS

A total of 120 patient's ≥18 years old were randomly divided into three groups of 40. The study groups received fentanyl 2 μg/kg thiopental 5 mg/kg and atracurium in doses 0.2 mg/kg, 0.4 mg/kg, and 0.6 mg/kg, respectively, based on the patient group. The conditions of LMA insertion, hemodynamic responses, and complications were evaluated and compared in the groups.

RESULTS

In the study groups, the LMA placement was difficult in 15%, 7.5%, and 2.5%, respectively ( = 0.13). There was no statistically significant difference among the groups regarding the success rate in the first attempt to the insertion of LMA. Of the three groups, 5%, 2.5%, and 2.5% had bleeding at the place of mask insertion ( = 0.77). 17.5%, 7.5%, and12.5% had sore throat, respectively ( = 0.4). No patient experienced laryngospasm during the study. Furthermore, changes in blood pressure, heart rate, and oxygen saturation were not significant in the three groups.

CONCLUSION

All three doses of atracurium have similar effects on the condition of LMA insertion. Atracurium 0.4 mg/kg accompanied by higher success on LMA insertion in the first attempt and lower airway complications (bleeding and sore throat), increasing this dose had no significant effect on the success rate of LMA insertion.

摘要

背景

在本研究中,我们旨在评估三种不同剂量的阿曲库铵在喉罩置入条件、首次尝试成功率及可能并发症方面的安全性和有效性。

材料与方法

总共120名年龄≥18岁的患者被随机分为三组,每组40人。根据患者分组情况,研究组分别接受2μg/kg芬太尼、5mg/kg硫喷妥钠以及0.2mg/kg、0.4mg/kg和0.6mg/kg剂量的阿曲库铵。对各组喉罩置入条件、血流动力学反应及并发症进行评估和比较。

结果

在研究组中,喉罩置入困难的比例分别为15%、7.5%和2.5%(P = 0.13)。各组在首次尝试置入喉罩的成功率方面无统计学显著差异。三组中,分别有5%、2.5%和2.5%的患者在面罩置入处出现出血(P = 0.77)。分别有17.5%、7.5%和12.5%的患者出现咽痛(P = 0.4)。研究期间无患者发生喉痉挛。此外,三组患者的血压、心率和血氧饱和度变化均不显著。

结论

三种剂量的阿曲库铵在喉罩置入条件方面具有相似的效果。0.4mg/kg剂量的阿曲库铵在首次尝试置入喉罩时成功率更高,气道并发症(出血和咽痛)更低,增加该剂量对喉罩置入成功率无显著影响。

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