Feasibility of induction with sevoflurane-midazolam-remifentanil for tracheal intubation without muscle relaxants in neck brake patients
10.3760/cma.j.issn.0254-1416.2010.12.008
- VernacularTitle:七氟醚-咪达唑仑-瑞芬太尼麻醉诱导用于颈部制动患者无肌松药气管插管的可行性
- Author:
Xuequan SHAO
;
Zhongxin PAN
;
Yunping LAN
;
Ling XU
;
Linsen ZHAN
;
Shufen YANG
;
Gongmin YU
;
Li HUANG
;
Lihua ZHENG
;
Fangpu WU
- Publication Type:Journal Article
- Keywords:
Anesthetics,inhalation;
Midazolam;
Piperdines;
Intubation,intratracheal;
Neck brake
- From:
Chinese Journal of Anesthesiology
2010;30(12):1435-1436
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the feasibility of induction with sevoflurane-midazolam-remifentail for tracheal intubation without muscle relaxants in neck brake patients.Methods Forty ASA Ⅰ or Ⅱ patients with cervical spine fracture with dislocation,aged 13-68 yr,scheduled for surgery under general anesthesia,were enrolled in this study.Anesthesia was induced with iv injection of midazolam 0.03 mg/kg and inhalation of 5%sevoflurane through a mask.Sevoflurane was inhaled at the initial concentration of 5%,followed by decrement of 1% every 30 s until 3%.When the eyelash reflex disappeared,remifentanil 2 μg/kg was injected slowly over 45s and 30 s later sevoflurane inhalation was stopped.The patients were mechanically ventilated after tracheal intubation.The time of disappearance of eyelash reflex was recorded.The intubation condition was evaluated using VibyMogensen score.Results All patients were successfully intubated at the first attempt.The time period from sevoflurane inhalation to disappearance of eyslash reflex was(69 ± 4)s.Coughing occurred in 3 cases during intubation.The satisfactory intubation conditions were found in 100% of cases.SpO2 ＞ 95% in all patients.BlS was maintained at 45-55 during the period(before intubation until 3 min after intubation).Conclusion Induction with sevoflurane-midazolam-remifentail is rapid and smooth,provides good conditions for intubation and can be applied to tracheal intubation without muscle relaxants in neck brake patients.
