Tracheal Intubation Condition And Haemodynamics Induced By Remifentanil

Objective: In this study we have compared the intubating conditions, haemodynamic changes in healthy adults following induction of anesthesia with propofol in combination with either remifentanil,vecuronium bromide or varying doses of remifentanil and spurt lidocaine 4 ml into trachea after induction. It will give a reference for hereafter clinic use of induction of anaesthesia with remifentanil without the use of neuromuscular blocking agents, its feasibility and safety were evaluated. Grope for a better dose of remifentanil about this kind of induction.Method: Choose 80 patients randomized into 4 groups as following : REMI GroupⅠ=propofol 2mg·Kg^-1 and remifentanil 2μg·Kg^-1 ; REMI GroupⅡ=propofol 2mg·Kg^-1and remifentanil 2.5μg·Kg^-1;REMI GroupⅢ= propofol 2mg·Kg^-1 and remifentanil 3μg·Kg^-1 ;Control Group= propofol 2mg·Kg^-1 and fentanil 2μg·Kg^-1,vecuronium bromide 0.1mg·Kg^-1.Premedication: Midazolam 0.06mg·Kg^-1 +Penehyclidine Hydroe hloride Injection 17μg·Kg^-1.After inducing 2min, we give laryngoscopy and spurt lidocaine 4 ml into trachea; then tracheal intubation. HR and MAP value were at recorded 3 min before induction , 1 min after induction, 1 and 3 min after tracheal intubation. An experienced, blinded anesthetist controlled the patients and assessed for five visibility of tracheal intubation. Results: The intubating conditions of the groups were similar. ( p>0.05),the control of cardiovascular responses to tracheal intubation with remifentanil is more effective than (after tracheal intubation 1,3minHR,p < 0.05)or similar(other haemodynamics indexes p > 0.05)that with fentanil. Conclusion:The combination of remifentanil 2-3μg·Kg^-1,propofol 2.0 mg·Kg^-1 and spurt lidocaine 4 ml into trachea could provided satisfactory intubating conditions and prevented cardiovascular intubation response. The technique may be an appropriate way when neuromuscular blockade is contraindicated for the patients.