Clinical Research Of Modified Rapid Sequence Induction In The Fast-track Surgery

Objective To evaluate the safety and efficacy of modified rapid sequence induction used in fast-track surgeryMethods Sixty patients, ASA Ⅰ～Ⅱ, scheduled for gastric cancer, colorectal cancer surgery under general anesthesia were randomly divided into two groups with30cases in eath group. Modified rapid sequence induction group (Group M):pre-inhaled oxygen at a rate of6L/min with tidal volume for3min, and then, vecuronium0.01mg/kg,midazolam0.02mg/kg, fentanyl1.0μg/kg were injected intravenous, after the patients inhaled oxygen at a rate of6L/min with tidal volume for2min, etomidate0.3mg/kg、vecuronium0.09mg/kg、midazolam0.03mg/kg、fentanyl3.0μg/kg were injected sequence, tracheal intublated when muscle relaxants completed with no positive pressure ventilation. Conventional rapid induction group (group C):pre-inhaled oxygen at a rate of6L/min for3min,midazolam0.05mg/kg, fentanyl4.oμg/kg, etomidate0.3mg/kg, vecuronium0.lmg/kg were injected intravenous, at the same time all of the patients inhaled oxygen at a rate of6L/min with positive pressure ventilation, tracheal intublated when muscle relaxants completed. Observed and recorded the HR, MAP, SPO2, PaO2(mmHg), PaCO2(mmHg) at the time of pre-induction(T1),post-induction2min(T2), post-intubation1min (T3) and post-intubation5min (T4) in two groups. PETCO2(mmHg) at the time of T3and T4, the changes of plasma cortisol (nmol/L) and blood glucose (mmol/L) at the time of T1,T3,T4.Results The demography in two groups was no significant difference (P>0.05); There was statistically difference of HR and MAP in group C at the time of post-induction2min (T2) compared with group M (P<0.05), the MAP and HR were not increased in group M at T3(P>0.05), however, the MAP and HR were significant increased at T3compared to T2in group C (P<0.05). The PaCO2were no statistically significant after induction2min (T2) in two groups. Plasma cortisol and blood glucose were no significant difference in two groups at T1-T4The anesthesia-related complications were not found after operation48hours in two groups.Conclusions The modified rapid sequence induction has more hemodynamic stability and lower stress response during tracheal intubation, and it is very well suitable for induction in fast-track surgery. Because of avoiding some complications such as reflux, aspiration and gastrointestinal flatulence, it has great benefits for clinical in fast-track surgery.