硫喷妥钠复合芬太尼与司可林对喉罩置入的麻醉效果

Efficacy of thiopental combined with fentanyl and low dose of succinylcholine for laryngeal mask airway insertion

目的评价硫喷妥钠复合芬太尼、小剂量司可林对喉罩置入的麻醉效果。方法拟行喉罩全麻患者120例,年龄18～60岁,ASAⅠ～Ⅱ级,随机分为3组:异丙酚-芬太尼组(PF组)、硫喷妥钠-芬太尼组(TF组)、硫喷妥钠-芬太尼-小剂量司可林组(TS组),每组40例。每组患者静脉注射芬太尼1μg/kg后2min,PF组静脉注射异丙酚2mg/kg,TF组静脉注射硫喷妥钠5mg/kg,TS组静脉注射硫喷妥钠5mg/kg和司可林0.5mg/kg,意识消失后置入喉罩。在喉罩置入时,评估患者下颌松弛情况和喉罩置入条件;记录在喉罩置入过程中咳嗽、干呕以及喉痉挛的发生情况;记录喉罩置入前、置入后1、2、3min时血压、心率;记录麻醉诱导完成后呼吸暂停时间。结果TS组与PF组的下颌松弛情况和喉罩置入条件优于TF组(P<0.05);TS组与PF组咳嗽、干呕、喉痉挛发生情况低于TF组(P<0.05)。TS组呼吸暂停时间长于PF组和TF组(P<0.05)。结论硫喷妥钠复合芬太尼与小剂量司可林麻醉可提供与异丙酚复合芬太尼麻醉相当的喉罩置入条件,且不良反应少。

Objective To evaluate the efficacy of thiopental combined with fentanyl and low close succinylcholine for laryngeal mask airway （LMA） insertion. Method The 120 ASA Ⅰ or Ⅱ patients aged 18-60 ）yr weighing 40-80kg undergoing general anaesthesia using the LMA were randomly divided into 3 groups （n=40 each）： PF group （propofol-fentanyl）, TF group （thiopental-fentanyl） and TS group （thiopental-fentanyl-low dose succinylcholine）. Two min after all patients received 1μg/kg^-1 fentanyl iv, PF group received propafol 2mg/kg^-1 iv, TF group received thiopental 5mg/kg^-1 iv, TS： group received thiopental 5mg/kg^-1 and succinylcholine 0.Smg/kg^-1 iv. The LMA was inserted after the patients lost consciousness. The grade of the jaw relaxation and the overall insertion conditions were assessed, the incidences of gagging, coughing and laryngospasm were recorded during the insertion of the LMA. Blood pressure and heart rate were recorded before and 1 min, 3 min after LMA insertion. The time of apnea after anesthesia induction was recorded. Result The jaw relaxation and the overall LMA insertion conditions in TS and PF groups were significantly better than in TF group （P〈0.05）. The incidences of gagging, coughing and laryngospasm in TS and PF groups were significandy lower than in TF group （P〈 0.05）： The time of apnea in TS group is significantly longer than in TF and PF groups （P〈0.05）. Conclusion The combination of thiopental with fentanyl and low close of succinylcholine can provide conditions comparable with those of the Combination of propofol with fentanyl for LMA insertion and reduce the adverse reaction to insertion of the LMA.