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：

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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, 钟声宏, 黄泽宗, 等. 瑞芬太尼复合咪达唑仑注射液用于纤维支气管镜引导下清醒气管插管的最佳剂量研究[J]. 实用临床医学, 2009, 10(10):50-51.
2.	王银模, 吴晓智, 江鹤群, 等. 右美托咪定用于清醒慢诱导气管插管的临床观察[J]. 临床麻醉学杂志, 2011, 27(6):582-583.
3.	余骏马, 陶汉, 董春山, 等. 瑞芬太尼抑制气管内表面麻醉时呛咳反射的半数有效血浆浓度[J]. 临床麻醉学杂志, 2011, 27(6):558-559.
4.	余德华, 陈文迪, 楼静芝. 氯胺酮复合异丙酚在烧伤、大面积换药等短小手术中的应用体会[J]. 河北医科大学学报, 2008, 29(2):257-258.
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7.	吴川, 赵明新. 瑞芬太尼、丙泊酚全静脉麻醉用于悬雍垂腭咽成型术的效果[J]. 河北医科大学学报, 2008, 29(1):102-103.
8.	刘晓芬, 胡宪文, 李云, 等. 帕瑞昔布钠复合吗啡对瑞芬太尼致骨科手术患者术后痛觉过敏的影响[J]. 中华麻醉学杂志, 2010, 30(5):545-548.
9.	王鹏, 吴永伟, 刘启明. 瑞芬太尼在经鼻蝶垂体瘤切除术中合适剂量的临床观察[J]. 临床麻醉学杂志, 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无痛纤支镜检查的临床观察[J]. 临床麻醉学杂志, 2010, 26(9):808-809.
12.	贾丽, 马艳辉, 邢玉英, 等. 靶控输注瑞芬太尼复合吸入异氟醚控制性降压对开颅手术患者血流动力学的影响[J]. 河北医科大学学报, 2009, 30(1):42-45.
13.	曾秋谷, 杨奕尤, 谢汝欢. 瑞芬太尼持续微泵输注复合小剂量异丙酚用于无痛肠镜的临床观察[J]. 临床和实验医学杂志, 2011, 10(8):587-589.
14.	程平瑞, 江伟航, 董静毅, 等. 纤维支气管镜清醒插管时不同剂量瑞芬太尼复合咪达唑仑的效果[J]. 中华麻醉学杂志, 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.	许亚超, 薛富善, 杨泉涌, 等. 瑞芬太尼抑制患者气管插管反应的半数有效剂量[J]. 中华麻醉学杂志, 2008, 28(10):873-876.

1. 石力, 钟声宏, 黄泽宗, 等. 瑞芬太尼复合咪达唑仑注射液用于纤维支气管镜引导下清醒气管插管的最佳剂量研究[J]. 实用临床医学, 2009, 10(10):50-51.
2. 王银模, 吴晓智, 江鹤群, 等. 右美托咪定用于清醒慢诱导气管插管的临床观察[J]. 临床麻醉学杂志, 2011, 27(6):582-583.
3. 余骏马, 陶汉, 董春山, 等. 瑞芬太尼抑制气管内表面麻醉时呛咳反射的半数有效血浆浓度[J]. 临床麻醉学杂志, 2011, 27(6):558-559.
4. 余德华, 陈文迪, 楼静芝. 氯胺酮复合异丙酚在烧伤、大面积换药等短小手术中的应用体会[J]. 河北医科大学学报, 2008, 29(2):257-258.
5. 庄心良, 曾因明, 陈伯銮. 现代麻醉学[M]. 3版. 北京:人民卫生出版社, 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. 吴川, 赵明新. 瑞芬太尼、丙泊酚全静脉麻醉用于悬雍垂腭咽成型术的效果[J]. 河北医科大学学报, 2008, 29(1):102-103.
8. 刘晓芬, 胡宪文, 李云, 等. 帕瑞昔布钠复合吗啡对瑞芬太尼致骨科手术患者术后痛觉过敏的影响[J]. 中华麻醉学杂志, 2010, 30(5):545-548.
9. 王鹏, 吴永伟, 刘启明. 瑞芬太尼在经鼻蝶垂体瘤切除术中合适剂量的临床观察[J]. 临床麻醉学杂志, 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无痛纤支镜检查的临床观察[J]. 临床麻醉学杂志, 2010, 26(9):808-809.
12. 贾丽, 马艳辉, 邢玉英, 等. 靶控输注瑞芬太尼复合吸入异氟醚控制性降压对开颅手术患者血流动力学的影响[J]. 河北医科大学学报, 2009, 30(1):42-45.
13. 曾秋谷, 杨奕尤, 谢汝欢. 瑞芬太尼持续微泵输注复合小剂量异丙酚用于无痛肠镜的临床观察[J]. 临床和实验医学杂志, 2011, 10(8):587-589.
14. 程平瑞, 江伟航, 董静毅, 等. 纤维支气管镜清醒插管时不同剂量瑞芬太尼复合咪达唑仑的效果[J]. 中华麻醉学杂志, 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. 许亚超, 薛富善, 杨泉涌, 等. 瑞芬太尼抑制患者气管插管反应的半数有效剂量[J]. 中华麻醉学杂志, 2008, 28(10):873-876.

West China Medical Journal

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

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