Effect of no-inotropic intravenous anesthesia in treatment of patients with moderate-to-severe airway stenosis through rigid bronchoscopy
HOU Qingwu1, XU Jing1, YANG Mingyuan1, YU Xiangdi2, CHENG Qinghao1, WANG Bin1
1. Department of Anesthesiology, Emergency General Hospital,Beijing 100028, China; 2. Department of Anesthesiology, Guizhou Provincial People's Hospital, Guiyang 550002,China
Abstract：Objective To evaluate the effect of no-inotropic intravenous anesthesia in the treatment of patients with moderate-to-severe airway stenosis through rigid bronchoscopy.Methods Sixty patients with moderate-to-severe airway stenosis from January 2020 to January 2021 treated through rigid bronchoscopy were randomly divided into no-inotropic group (group A) and the inotropic group (group B). We measured the mean arterial pressure (MAP), heart rate (HR), Bispectral index values (BIS) before induction of anesthesia (T0), at the time of rigidoscopy placement (T1), and after rigidoscopy placement (T2); vocal activity of patients at the time of rigidoscopy placement , choking of patients after rigidoscopy placement, operation time, awakening time, arterial blood gas analysis at the end of operation, intraoperative oxygen saturation below 90% , and the assessment of upper limb muscle strength were also measured.Results 53 patients completed the study, including 27 in the no-myorelaxant group and 26 in the myorelaxant group. There was no difference in the changes of MAP and HR between the two groups before and after rigidoscopy placement and there was no significant difference in operation time and awakening time. The blood gas analysis of lactate (Lac) was higher in group A(1.05±0.4)than in group B(0.8±0.3)(P<0.05). The difference in the incidence of intra operative hypoxemia between the two groups was not statistically significant. The incidence of choking was higher in group A 66.6% than in group B 19.2% (P< 0.05). The upper limb muscle strength against resistance at awakening was significantly better in group A 100% than in group B 46.1% (P<0.05).Conclusions No-inotropic intravenous anesthesia is a safe and feasible technique worth promoting because of the good recovery of patients' muscle strength and the low impact on respiratory function during rigid bronchoscopy treatment in patients with moderate to severe airway stenosis.
Hunter J M. Reversal of residual neuromuscular block: complications associated with perioperative management of muscle relaxation[J].Br J Anaesth,2017,119(Suppl 1):53-62.
Mclean D J, Diaz G D, Farhan H N, et al. Dose-dependent association between intermediate-acting neuromuscular-blocking agents and postoperative respiratory complications[J]. Anesthesiology,2015,122(6):1201-1213.
Yan W, Xiong Y, Yao Y,et al. Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeated cesarean section under epidural anesthesia, a prospective, randomized study[J].BMC Anesthesiol,2019,19(1):243.
Baene B,Plaud B,Dilly M P,et al.Residual paralysis in the PACU after a single intubating dose of nondepolarizing muscle relaxant with an intermediate duration of action[J]. Anesthesiology,2003,98(5):1042-1048.
[18]
Berg H,Roed J, Viby M J,et al. Residual neuromuscular block is a risk factor for postoperative pulmonary complications [J].Acta Anaesthesiol Scand,1997,41(9):1095-1103.
[19]
Murphy G S, Szokol J W, Marymont J H,et al. Residual neuromuscular blockade and critical respiratory events in the postanesthesia care unit[J]. Anesth Analg,2008,107(1):130-137
2022, Vol. 33 
