Clinical Research on Remifentanil-propofol for Tracheal Intubation in Patients who are Awake_West China Medical Journal

Authors：

 XIAOQing-wang , QINcai-juan , ZHUGuang-ping , MINYan-xu , TIANQing-chuan

Department of Anesthesiology, Luanxian People's Hospital, Luanxian, Hebei 063700, P. R. China;

Corresponding?author：

Keywords：

Remifentanyl; Endotracheal intubation; Propofol; Awake; Lidocaine

DOI：

10.7507/1002-0179.20140570

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To study the feasibility of using propofol and remifentanil for tracheal intubation in patients who are awake, and investigate the influence of tracheal intubation on such vital signs as blood pressure and heart rates. Methods Eighty ASA I-Ⅱ patients who underwent general anesthesia in our hospital between December 2012 and April 2013 were randomly divided into two groups. Patients in group A received fentanyl-propofol, while patients in group B received remifentanyl-propofol-lidocaine. There was no significant difference between the two groups in gender, age, and body weight (P>0.05). Conventional intubation induction method was used for group A:0.05-0.10 mg/kg midazolam, 4 μg/kg fentanyl, 1.0-1.5 mg/kg propofol, and 0.6-0.9 mg/kg atracurium were given and tracheal intubation was performed after muscle relaxation. Group B patients were treated with remifentanyl propofol-lidocaine compound liquid slow intravenous injection, and compound cricothyroid membrane puncture method before endotracheal intubation. We observed the two groups of patients for vital signs before and after induction, and choking cough reactions. Results Patients in both the two groups were all able to complete tracheal intubation. Circulation change and incidence of tachycardia in patients of group A were significantly higher than those in group B (P<0.05). The rates of bradycardia, hypoxemia, and choking cough response were low in both groups with no statistically significant difference (P>0.05). Conclusion Remifentanyl propofol-lidocaine compound liquid can be safely used for implementation of endotracheal intubation in patients who are awake, and the hemodynamic stability can be maintained.

Citation： XIAOQing-wang, QINcai-juan, ZHUGuang-ping, MINYan-xu, TIANQing-chuan. Clinical Research on Remifentanil-propofol for Tracheal Intubation in Patients who are Awake. West China Medical Journal, 2014, 29(10): 1887-1890. doi: 10.7507/1002-0179.20140570 Copy

1.	石力, 鐘聲宏, 黃澤宗, 等. 瑞芬太尼復合咪達唑侖注射液用于纖維支氣管鏡引導下清醒氣管插管的最佳劑量研究[J]. 實用臨床醫學, 2009, 10(10):50-51.
2.	王銀模, 吳曉智, 江鶴群, 等. 右美托咪定用于清醒慢誘導氣管插管的臨床觀察[J]. 臨床麻醉學雜志, 2011, 27(6):582-583.
3.	余駿馬, 陶漢, 董春山, 等. 瑞芬太尼抑制氣管內表面麻醉時嗆咳反射的半數有效血漿濃度[J]. 臨床麻醉學雜志, 2011, 27(6):558-559.
4.	余德華, 陳文迪, 樓靜芝. 氯胺酮復合異丙酚在燒傷、大面積換藥等短小手術中的應用體會[J]. 河北醫科大學學報, 2008, 29(2):257-258.
5.	莊心良, 曾因明, 陳伯鑾. 現代麻醉學[M]. 3版. 北京:人民衛生出版社, 2003:483-487.
6.	Nyman Y, Von Hofsten K, Georgiadi A, et al. Propofol injection pain in children:a prospective randomized double-blind trial of a new propofol formulation versus propofol with added lidocaine[J]. Br J Anaesth, 2005, 95(2):222-225.
7.	吳川, 趙明新. 瑞芬太尼、丙泊酚全靜脈麻醉用于懸雍垂腭咽成型術的效果[J]. 河北醫科大學學報, 2008, 29(1):102-103.
8.	劉曉芬, 胡憲文, 李云, 等. 帕瑞昔布鈉復合嗎啡對瑞芬太尼致骨科手術患者術后痛覺過敏的影響[J]. 中華麻醉學雜志, 2010, 30(5):545-548.
9.	王鵬, 吳永偉, 劉啟明. 瑞芬太尼在經鼻蝶垂體瘤切除術中合適劑量的臨床觀察[J]. 臨床麻醉學雜志, 2011, 27(8):802.
10.	Loop T, Priebe HJ. Recovery after anesthesia with remifentanil combined with propofol, desflurane, or sevoflurane for otorhinolaryngeal surgery[J]. Anesth Analg, 2000, 91(1):123-129.
11.	宋炯, 李明星, 段若望. 芬太尼和舒芬太尼用于無痛纖支鏡檢查的臨床觀察[J]. 臨床麻醉學雜志, 2010, 26(9):808-809.
12.	賈麗, 馬艷輝, 邢玉英, 等. 靶控輸注瑞芬太尼復合吸入異氟醚控制性降壓對開顱手術患者血流動力學的影響[J]. 河北醫科大學學報, 2009, 30(1):42-45.
13.	曾秋谷, 楊奕尤, 謝汝歡. 瑞芬太尼持續微泵輸注復合小劑量異丙酚用于無痛腸鏡的臨床觀察[J]. 臨床和實驗醫學雜志, 2011, 10(8):587-589.
14.	程平瑞, 江偉航, 董靜毅, 等. 纖維支氣管鏡清醒插管時不同劑量瑞芬太尼復合咪達唑侖的效果[J]. 中華麻醉學雜志, 2007, 27(6):493-495.
15.	O'hare R, Mcatameny D, Mirakhur RK, et al. Bolus does remifentanil for control of haemodynamic response to tracheal intubation during rapid sequence induction of anaesthesia[J]. Br J Anaesth, 1999, 82(2):283-285.
16.	許亞超, 薛富善, 楊泉涌, 等. 瑞芬太尼抑制患者氣管插管反應的半數有效劑量[J]. 中華麻醉學雜志, 2008, 28(10):873-876.

1. 石力, 鐘聲宏, 黃澤宗, 等. 瑞芬太尼復合咪達唑侖注射液用于纖維支氣管鏡引導下清醒氣管插管的最佳劑量研究[J]. 實用臨床醫學, 2009, 10(10):50-51.
2. 王銀模, 吳曉智, 江鶴群, 等. 右美托咪定用于清醒慢誘導氣管插管的臨床觀察[J]. 臨床麻醉學雜志, 2011, 27(6):582-583.
3. 余駿馬, 陶漢, 董春山, 等. 瑞芬太尼抑制氣管內表面麻醉時嗆咳反射的半數有效血漿濃度[J]. 臨床麻醉學雜志, 2011, 27(6):558-559.
4. 余德華, 陳文迪, 樓靜芝. 氯胺酮復合異丙酚在燒傷、大面積換藥等短小手術中的應用體會[J]. 河北醫科大學學報, 2008, 29(2):257-258.
5. 莊心良, 曾因明, 陳伯鑾. 現代麻醉學[M]. 3版. 北京:人民衛生出版社, 2003:483-487.
6. Nyman Y, Von Hofsten K, Georgiadi A, et al. Propofol injection pain in children:a prospective randomized double-blind trial of a new propofol formulation versus propofol with added lidocaine[J]. Br J Anaesth, 2005, 95(2):222-225.
7. 吳川, 趙明新. 瑞芬太尼、丙泊酚全靜脈麻醉用于懸雍垂腭咽成型術的效果[J]. 河北醫科大學學報, 2008, 29(1):102-103.
8. 劉曉芬, 胡憲文, 李云, 等. 帕瑞昔布鈉復合嗎啡對瑞芬太尼致骨科手術患者術后痛覺過敏的影響[J]. 中華麻醉學雜志, 2010, 30(5):545-548.
9. 王鵬, 吳永偉, 劉啟明. 瑞芬太尼在經鼻蝶垂體瘤切除術中合適劑量的臨床觀察[J]. 臨床麻醉學雜志, 2011, 27(8):802.
10. Loop T, Priebe HJ. Recovery after anesthesia with remifentanil combined with propofol, desflurane, or sevoflurane for otorhinolaryngeal surgery[J]. Anesth Analg, 2000, 91(1):123-129.
11. 宋炯, 李明星, 段若望. 芬太尼和舒芬太尼用于無痛纖支鏡檢查的臨床觀察[J]. 臨床麻醉學雜志, 2010, 26(9):808-809.
12. 賈麗, 馬艷輝, 邢玉英, 等. 靶控輸注瑞芬太尼復合吸入異氟醚控制性降壓對開顱手術患者血流動力學的影響[J]. 河北醫科大學學報, 2009, 30(1):42-45.
13. 曾秋谷, 楊奕尤, 謝汝歡. 瑞芬太尼持續微泵輸注復合小劑量異丙酚用于無痛腸鏡的臨床觀察[J]. 臨床和實驗醫學雜志, 2011, 10(8):587-589.
14. 程平瑞, 江偉航, 董靜毅, 等. 纖維支氣管鏡清醒插管時不同劑量瑞芬太尼復合咪達唑侖的效果[J]. 中華麻醉學雜志, 2007, 27(6):493-495.
15. O'hare R, Mcatameny D, Mirakhur RK, et al. Bolus does remifentanil for control of haemodynamic response to tracheal intubation during rapid sequence induction of anaesthesia[J]. Br J Anaesth, 1999, 82(2):283-285.
16. 許亞超, 薛富善, 楊泉涌, 等. 瑞芬太尼抑制患者氣管插管反應的半數有效劑量[J]. 中華麻醉學雜志, 2008, 28(10):873-876.

West China Medical Journal

Clinical Research on Remifentanil-propofol for Tracheal Intubation in Patients who are Awake

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content