Barclay K, Eggers K, Asai T
Department of Anaesthetics and Intensive Care Medicine, University Hospital of Wales, Heath Park, Cardiff.
Br J Anaesth. 1997 Jan;78(1):92-4. doi: 10.1093/bja/78.1.92.
We studied 60 adult patients to assess if low doses of rocuronium improved conditions for tracheal intubation during induction of anaesthesia with propofol 2.5 mg kg-1 and alfentanil 10 micrograms kg-1. In a double-blind, randomized design, patients were allocated to one of three groups: group P = saline; group R1 = rocuronium 0.1 mg kg-1; and group R3 = rocuronium 0.3 mg kg-1. Intubation conditions were judged as optimal, suboptimal or failure, based on the scoring of ease of jaw opening and laryngoscopy, position of the vocal cords and degree of straining after tracheal intubation. Intubation conditions were judged as optimal in one patient in group P, in six patients in group R1 and in 18 patients in group R3. Conditions were judged as a failure in seven patients in group P, in one patient in group R1 and in none in group R3. No laryngospasm or other complications were observed in any patient. The addition of low doses of rocuronium significantly improved intubation conditions (P < < 0.001). Ventilation was controlled during surgery, and in no patient was any problem encountered with antagonism of neuromuscular block with neostigmine. Injection of rocuronium 0.3 mg kg-1 (ED95) with propofol and alfentanil provided a high proportion of optimal intubation conditions.
我们研究了60例成年患者，以评估低剂量罗库溴铵是否能改善在使用2.5 mg/kg丙泊酚和10 μg/kg阿芬太尼诱导麻醉期间的气管插管条件。采用双盲、随机设计，将患者分为三组之一：P组 = 生理盐水；R1组 = 0.1 mg/kg罗库溴铵；R3组 = 0.3 mg/kg罗库溴铵。根据张口和喉镜检查的难易程度、声带位置以及气管插管后用力程度的评分，将插管条件判断为最佳、次佳或失败。P组有1例患者、R1组有6例患者、R3组有18例患者的插管条件被判断为最佳。P组有7例患者、R1组有1例患者的插管条件被判断为失败，R3组无失败病例。未观察到任何患者发生喉痉挛或其他并发症。添加低剂量罗库溴铵显著改善了插管条件（P << 0.001）。手术期间控制通气，使用新斯的明拮抗神经肌肉阻滞在任何患者中均未遇到任何问题。0.3 mg/kg（ED95）罗库溴铵与丙泊酚和阿芬太尼联合注射可提供高比例的最佳插管条件。
