Seavell C R, Cook T M, Cox C M
Royal Perth Hospital, Western Australia.
Anaesthesia. 1996 Jul;51(7):699-701. doi: 10.1111/j.1365-2044.1996.tb07860.x.
We assessed conditions for insertion of a laryngeal mask airway in 90 unpremedicated adult patients who received either thiopentone 5 mg.kg-1 preceded by 40 mg of topical lignocaine spray to the posterior pharyngeal wall or propofol 2.5 mg.kg-1 alone in a randomised, single-blinded trial. All patients received fentanyl 1 microgram.kg-1. Gagging, coughing and laryngospasm following laryngeal mask insertion were graded and haemodynamic data and apnoea times were recorded. There were no significant differences between the two groups with regard to the incidence of gagging, coughing and laryngospasm, but the apnoea time was significantly less in the thiopentone group (p < 0.005). The decrease in systolic and diastolic blood pressure, following induction and the insertion of a laryngeal mask with propofol was significantly greater than following thiopentone (p < 0.05--systolic, p < 0.01--diastolic). We conclude that thiopentone preceded by topical lignocaine spray provides conditions for insertion of a laryngeal mask equal to those of propofol, with more haemodynamic stability and a shorter period of apnoea.
在一项随机、单盲试验中，我们评估了90例未使用术前药的成年患者插入喉罩气道的情况。这些患者随机分为两组，一组在给予5mg/kg硫喷妥钠前，先向咽后壁喷洒40mg局部麻醉药利多卡因；另一组仅给予2.5mg/kg丙泊酚。所有患者均接受1μg/kg芬太尼。记录插入喉罩后的呛咳、咳嗽和喉痉挛情况并进行分级，同时记录血流动力学数据和呼吸暂停时间。两组在呛咳、咳嗽和喉痉挛的发生率方面无显著差异，但硫喷妥钠组的呼吸暂停时间明显更短（p<0.005）。诱导和插入喉罩后，丙泊酚组收缩压和舒张压的下降幅度明显大于硫喷妥钠组（收缩压p<0.05，舒张压p<0.01）。我们得出结论，在喷洒局部麻醉药利多卡因后使用硫喷妥钠，为插入喉罩提供的条件与丙泊酚相当，血流动力学更稳定，呼吸暂停时间更短。
