The Clinical Study Of Tracheal Intubation Without Muscle Relaxant After Induction Of Anesthesia With Sevoflurane In Infant

Objective:To approach the clinical application of tracheal intubation without muscle relaxant after induction of anesthesia with sevoflurane in infant.Methods:Forty-five ASAâ… orâ…¡infants,25 males,20 females aged 1～28months,weighing 3～14kg,undergone surgery under general anesthesia were enrolled in this study.They were randomly divided into 3 groups(n=15 average). Group C:control group;Group S:sevoflurane 8%in oxygen 4L/min;Group SL: sevoflurane 8%in oxygen 4L/min and 2%lidocaine for tracheal surface anesthesia.Every infant was given ketamine 6mg/kg im before entranced into the operating room.Induction was began after building up an intravenous transfusion,HR,BP,RR were monitored.Group C:anesthetic agents were given intravenous by turns,Midazolam 0.1mg/kg,propofol 2.5mg/kg,vecuronium 0.1 mg/kg,fentanyl 2μg/kg,tracheal intubation was performed in 4 minutes after the injection.Group S:Induction of anaesthesia was performed with sevoflurane 8% in oxygen 4L/min for 4 minutes and then intubated.Group SL:Induction of anaesthesia was performed with sevoflurane 8%in oxygen 4L/min for 4 minutes, tracheal surface anesthesia with 2%lidocaine then intubated.The HR,SBP, DBP value were recorded before induction(T₀);immediately before intubation(T₁);at 1 min after intubation(T₂);at 3 min after intubation(T₃).The results of tracheal intubation were graded as satisfied,average and poor based on intubation conditions and response including easiness of ventilating the infants via face mask,jaw relaxation,easiness of inserting laryngoscope and visualization of larynx,the vocal cord position and patient's response to intubation such as cough,limb movement and response to cuff inflation.Results:There was no significant difference in HR,BP at T₀,T₁,T₂,T₃ between groups(P＞0.05).BP(SBP DBP) were significantly depressed after induction compared with the baseline values before induction in all 3 groups(P＜0.05),while HR was significantly depressed at T₁ compared with T₀ in control group but remained stable in group S and group SL.All patients were successfully intubated at the first attempt,there was no significant difference between the three groups in intubation conditions.Conclusions:Induction of anesthesia with sevoflurane 8%in oxygen 4L/min without muscle relaxant might provide satisfactory intubation conditions in infant.