阿托品对小儿罗库溴铵气管内插管时间的影响

目的 评估全麻诱导前静注阿托品（ATR）对罗库溴铵（ROC）气管内插管时间（EItime）的影响.方法 美国麻醉医师学会（ASA）Ⅰ级、拟在全麻气管内插管下行骨科手术的患儿44例,随机分为阿托品组（A组,22例）及生理盐水对照组（C组,22例）.A组患儿全麻诱导前静注10 μg/kg ATR,B组静注5mL生理盐水.静注2 μg/kg芬太尼＋2.5 mg/kg丙泊酚＋0.3 mg/kg ROC,面罩100％氧气辅助呼吸后行气管内插管.EItime定义为ROC静注完毕至喉镜置入时间.采用Dixon序贯法测定两组患儿的EItime.结果 A组50％、95％患儿达到满意气管内插管条件的EItime及其95％ CI分别为146 s[143.8,148.9]、171 s[171.3,172.5],C组分别为175 s[173.1,177.9]、199s[198.8,200.7].与C组比较,A组50％、95％患儿达到满意气管插管条件的EItime均明显缩短（P＜0.05）.结论 芬太尼-丙泊酚静脉快速诱导时,使95％小儿达到满意气管插管条件0.3 mg/kgROC的EItime为199 s,全麻诱导前静注10 μg/kg ATR可缩短ROC的EItime至171 s.

Influence of atropine on endotracheal intubation time with rocuronium in children

Objective To evaluate the influence of atropine intravenous injection pre-anesthesia induction on the time of endotracheal intubation （ Eltime ） with rocuronium （ 0. 3 mg/kg） in children. Methods Forty-four ASA I children were randomly assigned to receive either 10 μg/kg atropine （Group A, n = 22 ） or normal saline （Group C, n =22） ,and the anesthesia was induced with 2 txg/kg fentanyl,2. 5 mg/kg propofol and 0. 3 mg/kg rocuroniurn. The Eltlme was defined as the time from the end of rocuronium injection to the start of laryngoscopy. Dixon sequential method was used to determine the EIame. Results The that provided satisfied intubation conditions in 50% and 95% of children in Group A was 146 s （95% confidence interval：143.8 - 148.9 s） and 171 s （95% CI：171.3 - 172. 5 s） , and those of group C were 175 s （95% CI：173. 1 - 177.9 s） and 199 s （95% CI：198.8 -200.7 s）,respectively, there were significant differences between the two groups （ P 〈 0. 05 ）. Conclusion The EItime of 0. 3 mg/kg rocuronium that provides satisfied intubation conditions in 95% of children induced with 2 μg/kg fentanyl and 2. 5 mg/kg propofol is 199 s, intravenous injection of 10 μg/kg atropine before induction can reduce the EIame to 171 s.