The application of surface anesthesia endotracheal intubation without muscle relaxant in the epiglottis vocal cords surgery anesthesia

Objective To evaluate the clinical application of surface anesthesia without muscle relaxant endotracheal intubation in epiglottis vocal cords surgery anesthesia. Methods Eighty patients undergoing elective epiglottis vocal cords surgery by general anesthesia,were randomly divided into two groups: In the anesthesia induction,the group of endotracheal intubation with muscle relaxants( group Ⅰ) was treated with intravenous cisatracurium 0. 1 mg / kg before endotracheal intubation. The group of surface anesthesia endotracheal intubation( group Ⅱ) used stepwise oropharyngeal and endotracheal surface anesthesia before endotracheal intubation.The changes of the mean arterial pressure( MAP) and heart rate( HR) were recorded in each time point before and after endotracheal intubation. These intubating conditions of two groups were compared. The operation time,intraoperation propofol and remifentanil dosage,the time of spontaneous breathing recovery and trached extubation after the end of the surgery were recorded and compared. The consciousness scores( OAA / S) of postoperative extubation were recorded. Postoperative adverse reaction,intraoperative awareness and the patientssatisfaction about anesthesia of two groups was compared. Results Seventy-eight patients of two groups have completed the clinical study. The change of MAP and HR had no statistically significant difference during endotracheal intubation between two groups( P 0. 05). The intubating conditions of two groups were similar. There was no statistically significant difference in the operation time and the total dosage between two groups( P 0. 05). There was a rapid recovery of spontaneous breathing and a early extubation in group Ⅱ compared with groupⅠ. The difference was significant( P 0. 05). The OAA / S score of groupⅡ was significantly higher than groupⅠwhen extubating or 5 min after extubating. Compared with groupⅠ,the postoperative adverse reactions in groupⅡ were less significantly. The patients of groupⅡ were more satisfied with anesthesia. Conclusion The surface anesthesia without using muscle relaxant endotracheal intubation may provided a good management of the airway and a safety recovery of the postoperation in patients undergoing epiglottis vocal cords surgery anesthesia.