Drage M P, Nunez J, Vaughan R S, Asai T
Department of Anaesthetics and Intensive Care Medicine, University of Wales College of Medicine, Heath Park, Cardiff.
Anaesthesia. 1996 Dec;51(12):1167-70. doi: 10.1111/j.1365-2044.1996.tb15062.x.
We have studied the efficacy of the loss of response to jaw thrust as a clinical test to assess adequate depth of anaesthesia for insertion of the laryngeal mask in 60 patients. After induction of anaesthesia with propofol (infused using a syringe driver), the patients were randomly allocated to one of two groups. In one group, insertion of the laryngeal mask was attempted immediately after the loss of verbal contact and in the other group, after the loss of motor response to a jaw thrust. Conditions for insertion of the laryngeal mask were assessed. The mean dose of propofol required to obtain loss of verbal contact was 1.94 mg.kg-1 (SD 0.39, 95% confidence intervals (CI) 1.79-2.08 mg.kg-1) and that for the loss of response to jaw thrust was 2.55 mg.kg-1 (SD 0.46, 95% CI 2.38-2.72 mg.kg-1). When depth of anaesthesia was assessed using jaw thrusting, it was always possible to insert the mask and the conditions were optimal in 87% (95% CI 72-95%) of patients. Neither coughing nor gagging occurred. In contrast, conditions were almost always less than optimal when insertion was attempted after the loss of verbal contact. Conditions were significantly better when jaw thrust was used as a clinical test compared with loss of verbal contact (p < < 0.001). No marked haemodynamic depression occurred in any patient. Thus, jaw thrust is a reliable clinical test to assess the adequate depth of anaesthesia for uncomplicated insertion of the laryngeal mask after induction of anaesthesia with propofol.
我们研究了对下颌前推反应消失作为一种临床测试，用于评估60例患者插入喉罩时麻醉深度是否足够的有效性。在用丙泊酚诱导麻醉（使用注射器泵输注）后，患者被随机分为两组。一组在言语接触消失后立即尝试插入喉罩，另一组在对下颌前推失去运动反应后插入。评估插入喉罩的条件。获得言语接触消失所需的丙泊酚平均剂量为1.94mg·kg-1（标准差0.39，95%置信区间（CI）1.79 - 2.08mg·kg-1），对下颌前推失去反应所需的剂量为2.55mg·kg-1（标准差0.46，95%CI 2.38 - 2.72mg·kg-1）。当使用下颌前推评估麻醉深度时，总是能够插入喉罩，87%（95%CI 72 - 95%）的患者条件最佳。既未发生咳嗽也未发生呛咳。相比之下，在言语接触消失后尝试插入时，条件几乎总是不理想。与言语接触消失相比，当下颌前推用作临床测试时条件明显更好（p << 0.001）。任何患者均未出现明显的血流动力学抑制。因此，下颌前推是一种可靠的临床测试，用于评估在用丙泊酚诱导麻醉后无并发症地插入喉罩时足够的麻醉深度。
