The Effect On Bronchial Ciliary Mucus Transport Velocity Of Patients With General Anesthesia By Different Clinic Dosages Of Remifentanil Hydrochloride

Volatile anesthetics reduce ciliary beat frequency in vitro. It has been reported that impaired bronchial mucus transport velocity (BTV) is associated with significantly increased pulmonary complications. Remifentanil has been used in clinic for deliberate hypotension for its effectiveness and easy control. Whereas, the effect of remifentanil on BTV in vivo is still not clear.Objective:This prospective randomised clinical trial was to compare the BTV in patients that having total intravenous anesthesia with different dosages of remifentanil at different anesthesia time.Methods:40 patients scheduled for elective surgery (ASA physical statusⅠtoⅡ) were randomly allocated to four groups (C, R1, R2, and R3). Patients in C group received anaesthesia with constant intravenous infusion of 0.04μg.kg-1.min-1 Fentanyl. Patients in R1, R2 and R3 groups received anesthesia by intravenous pumping 0.1μg.kg-1.min-1,0.2μg.kg-1.min-1, or 0.3μg.kg-1.min-1 Remifentanil respectively. After insertion of the laryngeal mask airway, BTV was assessed at 30min,60min and 120min by fibre-optic observation of the movement of methylene blue dye applied to the right main bronchus (modified Keller method). Results:There was no significant change of BTV at different time points in C group. The BTV in R groups were significantly reduced when the dosage of Remifentanil increased, and BTV was decreased as anaesthesia time increased as well. The BTV of R1, R2 and R3 groups were significantly reduced (p<0.05) when compared to C group at each time point. Conclusion:Compare to Fentanyl, BTV was significantly reduced in patients receiving remifentanil; higher dosage and longer usage of renifentail resulted in decreased BTV. Anaesthesia with Remifentanil may lead to significantly impaired bronchociliary clearance.