Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2011, Vol. 33 ›› Issue (4): 440-444.doi: 10.3881/j.issn.1000-503X.2011.04.018

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Induction of Tracheal Intubation without Muscle Relaxant by Target controlled Infusion of Propofol Combined with Remifentanil in Children

WEI Lingxin, DENG Xiaoming, WANG Lei, SUI Jinghu, ZHANG Yanming, TONG Shiyi, TANG Gengzhi, XU Kunlin   

  1. Department of Anesthesiology, Plastic Surgery Hospital, CAMS and PUMC, Beijing 100144, China
  • Received:2010-08-24 Revised:2011-09-05 Online:2011-08-01 Published:2011-08-01
  • Contact: DENG Xiao-ming

Abstract: Objective To observe the safety and feasibility of tracheal intubation by target-controlled infusion of propofol and remifentanil without muscle relaxant in children. Methods Totally 100 4-10-year-old pediatric patients (ASAⅠ) who had been scheduled for plastic surgery were equally divided into remifentanil group and control group through computer-generated randomized grouping. In all patients, five minutes after intravenous administration of atropine 0.01 mg/kg and midazolam 0.1 mg/kg, propofol was infused at the targeted effect-site concentration (Ce)of 6 μg/ml. When the intended target Ce of propofol was reached, the remifentanil group began to be infused with remifentanil at a Ce of 5 ng/ml, and normal saline (0.1 ml/kg) was injected simultaneously. In the control group,remifentanil was replaced by normal saline,and rocuronium (0.8 mg/kg) was injected together with the normal saline. After the equilibration of plasma and the Ce of remifentanil were reached, tracheal intubation was attempted. The complications during the induction and tracheal intubation were recorded. The intubating conditions were assessed using a five-point scoring system based on ease of laryngoscopy, vocal cords position, coughing, jaw relaxation and limb movement. Results The success rate of tracheal intubation was in 90% in remifentanil group and 98% in the control group (P=0.122).Conclusion Target-controlled infusion of propofol and remifentanil at Ce of 6 μg/ml and 5 ng/ml is feasible for the induction and tracheal intubation without muscle relaxant in children.

Key words: propofol, remifentanil, children, target-controlled infusion

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