Application of cisatracurium in clinical use of intubating laryngeal mask airway for painless bronchoscopy

Abstract:

Objective：To investigate the effect of cisatracurium in clinical use of intubating laryngeal mask airway for painless bron－choscopic diagnosis and therapy. Methods：Sixty patients were selected from October 2013 to February 2015 in our hospital who received painless bronchoscopy，and were randomly divided into observation group（n=30） and control group（n=30）. The intubating laryngeal mask airway was used in both groups for mechanical ventilation. The cisatracurium was used for the patients in observation group. Vital signs include mean arterial pressure（MAP），heart rate（HR），pulse oxygen saturation（SPO2），end-tidal carbon dioxide partial pressure（ETCO2） and bispectral index（BIS） were recorded at four points，anesthesia induction（T1），laryngeal mask insertion （T2），fiberoptic bronchoscope passing through the glottis（T3），end of diagnosis（T4）. The spontaneous breathing recovery time，the awakened eye opening time，extubation time and the time of postanesthesia staying in care unit in both groups were recorded and e－valuated. Results：The MAP and HR at T3 point were significantly lower in observation group than in control group（P=0.000）. The SPO2 at T3 point were significantly higher in observation group than in control group（P=0.000）. The ETCO2 at T2，T3，T4 at points were significantly lower in observation group than in control group（P=0.001，P=0.000，P=0.000）. There was no significant difference of BIS in both groups（P=0.235，P=0.614，P=0.455，P=0.546）. The doses of fentanyl and propofol were obviously reduced in observation group than in control group（P=0.000，P=0.000）. There was no significant statistically differences in the outcomes of general anesthesia（P=0.378）. There was no significant differences in the awakened eye opening time，extubation time and the time of postanesthesia staying in care unit in both groups（P=0.057，P=0.071，P=0.094）. The spontaneous breathing recovery time was significantly longer in observation group than in control group（P=0.030）. Conclusion：Low cisatracurium，as a muscle relaxant，is a helpful supplementary drug in clinical use of intubating laryngeal mask airway for painless bronchoscopy with more stable hemody－namics，which also can reduce the consumption of sedative or analgesic drugs and show no increase on the time in PACU.