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Injection pain, intubating conditions and cardiovascular changes following induction of anaesthesia with propofol alone or in combination with alfentanil

 

作者: L. SAARNIVAARA,   U‐M. KLEMOLA,  

 

期刊: Acta Anaesthesiologica Scandinavica  (WILEY Available online 1991)
卷期: Volume 35, issue 1  

页码: 19-23

 

ISSN:0001-5172

 

年代: 1991

 

DOI:10.1111/j.1399-6576.1991.tb03235.x

 

出版商: Blackwell Publishing Ltd

 

关键词: Alfentanil;anesthetic induction;injection pain;propofol;tracheal intubation

 

数据来源: WILEY

 

摘要:

In a double‐blind study, propofol (P) 2–2. 5 mg‐kg‐1preceded by saline (Sal) or alfentanil (A) 20–30 Hg kg‐1was used for anaesthetic induction in 59 young patients of ASA physical class I or II, premedicated with oxycodone 0. 1 mg‐kg‐1and atropine 0. 01 m. kg‐1i. m. The patients were randomly allocated to one of the four groups: Group 1 Sal + P2. 5, Group 2 A20 + P2. 5, Group 3 A30 + P2. 5 and Group 4 A30 + P2. Pain on injection of propofol occurred in 67, 36 and 7% of the patients in the Sal + P2. 5, A20 + P2. 5 and A30 + P2 groups, respectively, but not at all in the A30 + P2. 5 group. Intubating conditions were assessed as good, moderate, poor or impossible on the basis of jaw relaxation, ease of insertion of the tube and coughing on intubation, each on a three‐point scale. In impossible cases, suxamethonium was used. In the Sal + P2. 5 group, the frequencies of good, moderate, poor and impossible intubating conditions were 0, 38, 8 and 54%, respectively. The corresponding figures in the A30 + P2. 5 group were 43, 46, 7 and 14% (P<0. 05 between the groups). The other groups did not differ significantly from the Sal + P2. 5 group. After injection of propofol, both systolic and diastolic arterial pressures decreased significandy in all other groups, with the exception of diastolic pressure in the Sal + P2. 5 group, whereas heart rate did not differ from the control level. After intubation, systolic arterial pressure increased statistically significantly in the Sal + P2. 5 and A30 + P2 groups and diastolic arterial pressure in all other groups with the exception of the A30 + P2. 5 group when compared with the corresponding preceding values. After intubation, heart rate decreased significantly in the A30 + P2. 5 and A30 + P2 groups. The mean QTc interval of the ECG was always in the normal range. It is concluded that the best method was the combination of alfentanil 30 Ug‐kg‐1and propofol 2. 5 mg'kg“‘. It caused no pain on injection of propofol, offered satisfactory (good or moderate) intubating conditions in 79% of the patients and prevented the cardiov

 

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