Application Of Sufentanil Given By Tci Combined With Blind Tracheal Intubation Instrument On Difficult Intubation

Objective: To study the effect of different target concentrations ofsufentanil combined with blind tracheal intubation instrument(BTII) on difficultintubation, and explore the appropriate target concentration of sufentanil.Methods: Sixty ASA Ⅰ or Ⅱ with difficult airway of oral andmaxillofacial diseases undergoing elective surgery were randomly divided intothree groups. Each group received a fixed sufentanil target concentration of0.18ng/ml (group Ⅰ),0.22ng/ml (group Ⅱ),0.26ng/ml (group Ⅲ), respectively.SBP, DBP, MAP, HR, SpO2, the cases of respiratory depression, cough andsuccess intubation, as well as intubation time and complications were recordedat the time points of baseline (T0), before intubation (T1), at intubation (T2),3min (T3) and5min (T4) after intubation.Results: Compared with T0, there were no significant differences in theMAP and HR at T2, the MAP and HR at T1, T3, T4significantly decreased (P＜0.05), and the MAP at T3, T4was much higher than that of T1(P＜0.05). TheHR at T3significantly decreased compared with T1, and decreased to the lowestpoint at T4(P＜0.05). There were no significant differences in the values ofhemodynamic parameters among the three groups at each point (P＞0.05). The success rate of intubation of the three groups was90%,100%and95%,respectively (P＞0.05). Three cases failed, and were completed in other ways.Intubation time of three groups had no obvious difference (P＞0.05), whichwas (13.5±5.1) min,(11.9±2.5) min and (13.1±4.6) min. The cough rate ofgroup Ⅰ (75%) was much higher than that of group Ⅱ (35%) and Ⅲ (20%)(P＜0.05), however, the incidence of respiratory depression was just the opposite,it was40%in group Ⅲ,which was much higher than group Ⅰ (5%) and groupⅡ (15%)(P＜0.05). The other complications had no significant differences (P＞0.05).Conclusion: In combination with midazolam and etomidate, thehemodynamics can be kept stable during difficult intubation using BTII bythree target concentrations of sufentanil, but target concentration of0.22ng/mlis more suitable for difficult airway patients with less respiratory depression andlow incidence of cough.