目的：在以Propofol誘導下，要成功的置放喉頭罩呼吸道(LMA)需要適度張口動作及減低呼吸道反射，如作嘔、咳嗽或喉頭痙攣。我們假設，在使用Propofol為麻醉誘導藥物時，併用fentanyl或succinylcholine可以減少呼吸道反射的發生率，及增加喉頭罩呼吸道置放的成功率。方法：共60位排定接受全身麻醉手術，ASA Ⅰ-Ⅱ的成年患者隨機分為組：(1) Propofol 2mg/kg (2) Fentanyl 2μg/kg，及Propofol 2mg/kg (3) Propofol 2mg/kg，及 succinylcholine 0.5mg/kg。在麻醉前給藥atropine 0.01mg/kg後，記錄下由開始給予fentanyl或麻醉誘導藥物後，到所需之下顎放鬆的時間，並檢視患者在給藥後是否有躁動動作，以及在喉頭罩置入後，有無呼吸道反射情形發生。我們使用student's t test及Chi-square test來分析資料。以p<0.05為有顯著意義。結果：這3組中，病患的基本資料並無顯著差異。在以propofol誘導併fentanyl或succinylcholine下，可以比單純用Propofol誘導明顯縮短置入喉頭罩呼吸道的時間，減少喉頭罩置入後的呼吸道反射，及增加喉頭罩置放的成功率。在這兩種輔助藥物中，併用fentanyl或succinylcholine在於Propofol誘導時，並無明顯差異。結論：在喉頭罩置放時的麻醉誘導藥物上，單獨用Propofol 2mg/kg並不足夠。併用fentanyl 2μg/kg或succinylcholine 0.5mg/kg於propofol誘導時，可明顯增加喉頭罩置放成功率。雖然併用succinylcholine或併用fentanyl比單獨用Propofol誘導提供了較滿意的結果，但兩組間沒有顯著差異。對這兩種輔助藥物未來的研究，應著眼於麻醉術後的副作用。
Purpose: The successful insertion of a laryngeal mask airway (LMA) during propofol induction requires a proper mouth opening and minimal obstructive airway reflexes. We hypothesized that the concurrent use of fentanyl or succinylcholine in a propofol induction could reduce the occurrence of airway reflex and increase the success rate of laryngeal mask airway insertion. Methods: We randomly allocated 60 enrolled patients (scheduled to undergo surgery under general anesthesia) into three treatment groups: (1) propofol 2 mg/kg only; (2) propofol 2 mg/kg with fentanyl 2 μg/kg; (3) propofol 2 mg/kg with succinylcholine 0.5 mg/kg. After premedication with atropine (0.01 mg/kg, intravenous), we recorded the interval between the introduction of the treatment and the time of jaw relaxation, any excitatory movements after administering the induction agents and, after inserting the laryngeal mask, checked their airway reflex. Student's t test and Chi-square test were used to analyze the data. Results: Demographic data for all three groups were statistically identical. The concurrent use of fentanyl or succinylcholine during propofol induction significantly shortened LMA insertion time, decreased airway reflex, and increased the success rate of LMA insertion when compared to use of propofol alone. No process difference was found between the two adjuncts, fentanyl and succinylcholine. Conclusions: As an induction agent for the insertion of LMA, propofol alone (2 mg/kg ) is not recommended. Adding either fentanyl (2 μg/kg) or succinylcholine (0.5 mg/kg) significantly, and equally, improves the success rate. A further evaluation should be made to consider adverse postoperative effects.
