| Objective:To compare the clinical effect of sevoflurane or propofol combined with targeted controlled infusion(TCI) of sufentanil in patients undergoing endotracheal intubation without muscle relaxants using bronchofiberscope.Methods:60 patients undergoing selective operations under general anesthesia, aged 18-65 years old, BMI 18.5-24, classified ASAâ… ~â…¡, were randomized divided into two groups according to randomized number table(n=30): group sevoflurane(group S) and group propofol(group P). After entering the operation room, patients were monitored with ECG,mean arterial pressure(MAP), heart rate(HR) and pulse oxygen saturation(Sp O2), the intravenous access were established, and the infusion rate during induction of anesthesia was maintained at 4ml/min. Midazolam 2mg was administrated, nasal catheter oxygen was kept for 5min(2L/min), and the muscle relaxation monitor was connected. In the two groups, Adjust the effect compartment concentration of sufentanil to 0.3ng/ml,input gender, age, height, weight of patients. Plasma concentration of propofol was set at3.5 ug/ml and then start induction. When Sp O2<90%, holding up the jaw, if it does not work, assisted respiration was conducted. Tide Volume was administrated in group sevoflurane for induction. Before induction, patients were informed of the organic solvent gas smell, then make the bag empty, adjust the evaporator to 8%, the fresh gas flow to 8L/min and release the breathing bag, make facial mask closely to patients for deep breathe. When patients lost consciousness, had no reaction to loudly ask and eyelash reflex disappeared, turned the evaporator concentration to 4%, fresh gas flow to 4 L/min,when the mandibular of patients relaxed, OAA/S < 2, start to intubate under the guidanceof bronchoscopy. When patients entering operation room(T0), before induction(T1), after induction(T2), right after intubation(T3), at 1 min after intubation(T4), 2 min after intubation(T5); the TOF(%) were recorded before induction, after induction and after intubation; the time of consciousness loss, induction and intubation were recorded; the depth of bronchofiberscope and endotracheal intubation and the Observer’s Assessment of Alertness/Sedation Scale(OAA/S) were recorded; the incidences of adverse reactions during induction and at 24 h after operation were also recorded.Results:Compared between two groups, MAP in group P decreased significantly at T2 than that in group S, HR at T2, T3, T4, T5 in group P were higher than those in group S, in group P, the time of consciousness loss and induction were longer than those in group S, and the case number of administration of ephedrine in group P was larger than that in group S(P<0.05); and the MAP and HR at other time points between two groups were no statistic differences(P>0.05), intubation time, depth of bronchofiberscope and endotracheal intubation, the case number of administrating atropine, TOF(%), OAA/S after intubation and incidence rate of adverse effects between two groups were no statistic differences(P>0.05). Compared with T1, in group P, MAP at T2, T3 were decreased, HR at T3 was higher; While in group S, MAP at T2, T3 decreased, HR at T2 increased(P<0.05), and at other time points, there was no significantly statistic differences(P>0.05).Conclusion:Both sevoflurane and propofol combined with sufentanil could be used safely in the induction of patients undergoing general anesthesia and endotracheal intubation without muscle relaxants and provide good intubation condition. |
