เปรียบเทียบการนำสลบด้วยยา Propofol และยาผสมระหว่าง propofol - thiopentone กับประสิทธิภาพในการใส่หน้ากากครอบกล่องเสียง ProsealTM
เพ็ญนภา อริยะพณิช
กลุ่มงานวิสัญญีวิทยา โรงพยาบาลราชบุรี จังหวัดราชบุรี 70000
บทคัดย่อ
Background: The ProsealTM is commonly used for airway management during general anesthesia in Ratchaburi Hospital. Intravenous propofol (1%) has been used as an induction of choice for LMA insertion. However, the recommended dose of propofol 2.5 mg.kg-1 given intravenously could be associated with cardiovascular and respiratory depression.
Objectives: to assess insertion condition and hemodynamic responses by comparing propofol
(1%) and an admixture of propofol 0.5% and thiopentone 1.25% (1:1) during induction of anesthesia.
Methods: In a prospective, randomized controlled study, 190 nonpremedicated patients undergoing elective surgery were allocated into two groups: Group P received propofol 1%.
Group PT received an admixture of propofol 0.5% and thiopentone 1.25% (1:1), both at a dose of 0.25 ml.kg-1. The insertion condition, ease of insertion, apnea time and hemodynamic responses between the two groups were assessed.
Results: The incidences of resistance to mouth opening, resistance to insertion and coughing were significantly higher in the PT group than the P group (P = 0.017). There was no difference in terms of swallowing, movement and apnea time between the two groups. None of patients developed laryngospasm. Decrease in MAP and HR during administration of Propofol – thiopentone admixture was significantly less than administration of Propofol alone.
Conclusions: In nonparalyzed patients, propofol provides better conditions and easier ProsealTM insertion, but has greater hemodynamic instability than an admixture of propofol 0.5% and thiopentone 1.25% (1:1).
 
ที่มา
วิสัญญีสาร ปี 2557, April-June ปีที่: 40 ฉบับที่ 2 หน้า 107-115
คำสำคัญ
Propofol, Proseal, laryngeal mask airway, thiopentone