Abstract：
To compare outcomes between two standard-of-care anesthesia regimens for operative laryngoscopy: general anesthesia with a neuromuscular blocking agent (NMBA) versus remifentanil and propofol (non-NMBA).
This was a prospective, single-blinded, randomized controlled trial at a tertiary care center. Patients were randomized to either anesthesia using rocuronium (NMBA) or with remifentanil/propofol infusion alone (non-NMBA). Intraoperative impressions, anesthesia data, and post-operative patient surveys were collected.
Sixty-one patients who underwent suspension laryngoscopy from 2020 to 2022 were included (25 female, 36 male, ranging 20-81 years). Thirty patients were enrolled in the NMBA arm and 31 patients in the non-NMBA arm. Heart rate and mean arterial pressure were higher in the NMBA (p < 0.01). Patients in the non-NMBA group were more likely to require vasopressors (p = 0.04, RR = 3.08 [0.86-11.05]). Surgeons were more frequently satisfied with conditions in the NMBA group (86.7%) compared to the non-NMBA group (58.1%, p < 0.01). Procedures were more likely to be paused due to movement in the non-NMBA group (45.1%) compared to the NMBA group (16.6%, p < 0.03, RR = 2.26 [1.02-4.99]). Patients in the non-NMBA group were more likely to endorse myalgia the week after surgery (44%) compared to the NMBA group (8.3%, p < 0.01) and reported higher average pain levels on a 0-10 pain scale (3.7) compared to the paralysis group (2.0).
Anesthesia with rocuronium was associated with better intraoperative conditions and postoperative pain compared to anesthesia with remifentanil/propofol. Remifentanil/propofol were associated with lower blood pressure and suppression of laryngoscopy-associated tachycardia.
2 Laryngoscope, 133:2654-2664, 2023.
This was a prospective, single-blinded, randomized controlled trial at a tertiary care center. Patients were randomized to either anesthesia using rocuronium (NMBA) or with remifentanil/propofol infusion alone (non-NMBA). Intraoperative impressions, anesthesia data, and post-operative patient surveys were collected.
Sixty-one patients who underwent suspension laryngoscopy from 2020 to 2022 were included (25 female, 36 male, ranging 20-81 years). Thirty patients were enrolled in the NMBA arm and 31 patients in the non-NMBA arm. Heart rate and mean arterial pressure were higher in the NMBA (p < 0.01). Patients in the non-NMBA group were more likely to require vasopressors (p = 0.04, RR = 3.08 [0.86-11.05]). Surgeons were more frequently satisfied with conditions in the NMBA group (86.7%) compared to the non-NMBA group (58.1%, p < 0.01). Procedures were more likely to be paused due to movement in the non-NMBA group (45.1%) compared to the NMBA group (16.6%, p < 0.03, RR = 2.26 [1.02-4.99]). Patients in the non-NMBA group were more likely to endorse myalgia the week after surgery (44%) compared to the NMBA group (8.3%, p < 0.01) and reported higher average pain levels on a 0-10 pain scale (3.7) compared to the paralysis group (2.0).
Anesthesia with rocuronium was associated with better intraoperative conditions and postoperative pain compared to anesthesia with remifentanil/propofol. Remifentanil/propofol were associated with lower blood pressure and suppression of laryngoscopy-associated tachycardia.
2 Laryngoscope, 133:2654-2664, 2023.
摘要：
目的：比较两种标准麻醉方案用于喉镜手术的结果：神经肌肉阻滞剂全身麻醉（NMBA）与瑞芬太尼和丙泊酚（非NMBA）。
方法：这是一个前瞻性的，单盲,三级护理中心的随机对照试验。患者被随机分为使用罗库溴铵（NMBA）或单独输注瑞芬太尼/丙泊酚（非NMBA）的麻醉。术中印象,麻醉数据,收集术后患者调查。
结果：纳入了从2020年至2022年接受支撑喉镜检查的61例患者（25名女性，36男,20-81岁）。30名患者纳入NMBA组，31名患者纳入非NMBA组。NMBA组心率和平均动脉压较高(p<0.01)。非NMBA组患者更可能需要血管加压药（p=0.04，RR=3.08[0.86-11.05]）。与非NMBA组（58.1％，p<0.01)。由于非NMBA组的移动（45.1％），与NMBA组（16.6％，p<0.03,RR=2.26[1.02-4.99])。与NMBA组相比，非NMBA组的患者在手术后一周更有可能认可肌痛（44％）（8.3％，p<0.01），并在0-10疼痛量表（3.7）上报告的平均疼痛水平高于瘫痪组（2.0）。
结论：与瑞芬太尼/丙泊酚麻醉相比，罗库溴铵麻醉具有更好的术中条件和术后疼痛。瑞芬太尼/丙泊酚与降低血压和抑制喉镜相关的心动过速有关。
方法：二级喉镜，2023年。
方法：这是一个前瞻性的，单盲,三级护理中心的随机对照试验。患者被随机分为使用罗库溴铵（NMBA）或单独输注瑞芬太尼/丙泊酚（非NMBA）的麻醉。术中印象,麻醉数据,收集术后患者调查。
结果：纳入了从2020年至2022年接受支撑喉镜检查的61例患者（25名女性，36男,20-81岁）。30名患者纳入NMBA组，31名患者纳入非NMBA组。NMBA组心率和平均动脉压较高(p<0.01)。非NMBA组患者更可能需要血管加压药（p=0.04，RR=3.08[0.86-11.05]）。与非NMBA组（58.1％，p<0.01)。由于非NMBA组的移动（45.1％），与NMBA组（16.6％，p<0.03,RR=2.26[1.02-4.99])。与NMBA组相比，非NMBA组的患者在手术后一周更有可能认可肌痛（44％）（8.3％，p<0.01），并在0-10疼痛量表（3.7）上报告的平均疼痛水平高于瘫痪组（2.0）。
结论：与瑞芬太尼/丙泊酚麻醉相比，罗库溴铵麻醉具有更好的术中条件和术后疼痛。瑞芬太尼/丙泊酚与降低血压和抑制喉镜相关的心动过速有关。
方法：二级喉镜，2023年。
