丙泊酚、罗库溴铵全麻诱导后气管插管时间窗的临床研究

目的 观察靶控输注丙泊酚和舒芬太尼诱导期间,静脉注射罗库溴铵后1、2、3、4 min时的声门暴露情况、气管插管条件,寻找此条件下理想的气管插管时间窗.方法 120例择期全麻手术患者,年龄18～55岁,ASAⅠ～Ⅱ级,排除可能气管插管困难者,根据肌松药注射后插管时间随机分为R1 min组、R2 min组、R3 min组、R4 min组,每组30例.靶控输注丙泊酚(血浆靶浓度3.5μg/ml)、舒芬太尼(效应室靶浓度0.3 ng/ml),注射罗库溴铵(0.9 mg/kg)后分别于预设时间行气管插管,观察各组气管插管条件和声门暴露程度.结果 R1 min组声门暴露程度与其余3组比较差异有显著性,R2 min组、R3 min组、R4 min组声门完全暴露率优于R1 min组,R2 min组、R3 min组、R4 min组之间比较无显著差异.结论 罗库溴铵给药后2～4 min时比1 min时声门暴露程度更满意,是该药在靶控输注丙泊酚和舒芬太尼全麻诱导下理想的气管插管时间窗.

Time window for intubation after rocuronium administration during target-controlled infusion of propofol and sulfentanil

Objective To define the ideal time window for intubation after rocuronium administration during target-controlled infusion(TCI)ofpropofol and sulfentanil.Methods One hundred and twenty elective surgical patients(age range 18-55 years)were randomized into 4 groups(n=30)according to the intubation time after administration of the muscle relaxant.Patients with predicted difficult airway were excluded.General anesthesia was induced by TCI of propofol and sulfentanil.A senior anesthesiologist blinded for the randomization performed the intubations at 1,2,3,or 4 min after injection of rocuronium,and the vocal card visibility was evaluated upon full exposure of the vocal cord and the intubation conditions assessed according to Cooper's score.Results The intubation conditions were excellent or good in all patients,but the vocal cord visibility at 2-4 min differed significantly from that at 1 min after rocuronium administration(P<0.01).Suppression of the neuromuscular function 1 min after rocuronium administration differed significantly from that at other time points(P<0.01).Conclusion The condition of vocal cord can be more suitable for intubation at 2-4 min than at 1 min after rocuronium administration as the ideal time window for intubation during TCI of propofol and sulfentanil.