目的:启动原则是指给予小剂量的非去极化阻断剂,当随后进行大剂量插管时,会产生相对快速和深刻的阻滞,以确保气管内插管的合适条件。我们的目的是比较罗库溴铵的效果,维库溴铵,和阿曲库铵作为“预处理”药物在插管条件下使用罗库溴铵促进气管内插管。
方法:这种双盲,我们在三级医疗保健医院对在全身麻醉下接受外科手术的患者进行了随机对照前瞻性研究.通过计算机生成的随机化图将他们随机分为三组(n=35),接受罗库溴铵(0.06mg/kg体重)(A组);维库溴铵(0.01mg/kg体重)(B组)或,阿曲库铵(0.05mg/kg体重)(C组),然后插管剂量(0.6mg/kg体重)的罗库溴铵。血液动力学参数和插管条件进行了研究,并通过ANOVA检验和Student'st检验进行了统计分析,适用于社会科学16.0forwindows(SPSSInc.,芝加哥,IL,美国)。
结果:C组患者的最大数量(97.41%)观察到良好的插管条件。在所有时间间隔内,所有三组的收缩压均未观察到显着差异。平均动脉压从基线值显着上升到最大值,在所有组中的\'0\'min;但是,各组间差异无统计学意义(P>0.05)。
结论:用罗库溴铵预处理可以在60s内促进气管插管,而不考虑用于启动的非去极化肌肉松弛剂;然而,它不能减弱与喉镜和插管相关的血流动力学变化。
OBJECTIVE: Priming principle refers to administration of a small dose of non-depolarising blocker, which when followed by a large intubating dose produces a relatively rapid and profound blockade to ensure suitable conditions for endotracheal intubation. We aimed to compare the effects of rocuronium, vecuronium, and atracurium as \"pretreatment\" drugs on intubating conditions with rocuronium facilitated endotracheal intubation.
METHODS: This double-blinded, randomised controlled prospective study was carried out at a tertiary health care hospital on patients undergoing surgical procedures under general anaesthesia. They were randomly allocated into three groups (n = 35) by computer generated randomisation chart to receive either rocuronium (0.06 mg/kg body weight) (Group A); vecuronium (0.01 mg/kg body weight) (Group B) or, atracurium (0.05 mg/kg body weight) (Group C), followed by intubating dose (0.6 mg/kg body weight) of rocuronium. The haemodynamic parameters and intubating conditions were studied and statistically analysed by ANOVA test and Student\'s t-test as applicable using statistical package for the social sciences 16.0 for windows (SPSS Inc., Chicago, IL, USA).
RESULTS: Excellent intubating conditions were noted in maximum number of patients in Group C (97.41%). No significant differences were observed in the systolic blood pressure in all the three groups at all-time intervals. The mean arterial pressure rose significantly from baseline value to maximum, at \'0\' min in all the groups; however, no significant difference was observed amongst the groups (P > 0.05).
CONCLUSIONS: Pretreatment with rocuronium bromide can facilitate endotracheal intubation in 60 s irrespective of non-depolarising muscle relaxants used for priming; however, it cannot attenuate haemodynamic changes associated with laryngoscopy and intubation.