Comparison of Propofol and Remifentanil with Tracheal Intubation and Propofol and Ketamine without Tracheal Intubation in Burn Surgery

Objective To compare the characteristics of propofol and remifentanil with tracheal intubation and propofol and ketamine without tracheal intubation in burn surgery.Methods Sixty ASAⅠorⅡpatients undergoing elective burn surgery were randomly divided into ketamine group(group A,n=30) and remifentanil group(group B,n=30).In group A,anesthesia was induced with diazepam and ketamine and maintained by pumping propofol and ketamine without tracheal intubation.In group B,anesthesia was induced with diazepam,atracurium besilate,propofol and remifentanil,and then the patients were mechanically ventilated after tracheal intubation,and anesthesia was maintained by pumping propofol,atracurium besilate and remifentanil.The changes of MAP,HR,SpO2 and untoward effect during and after surgery were observed at five different time:points-pre-anesthesia(T1),post anesthesia induction(T2),0 minute(T3),45 minutes post beginning of surgery(T4) and 5 minutes post surgery(T5).Results MAP was rose significantly at T2 in group A(P0.05),but declined significantly in group B(P0.05).SpO2 declined at T2 in group A(P0.05),but rose in group B(P0.05).The recovery time in group B was shorter than that in group A(P0.01).The untoward effects such as dysphoria,phrenitis and respiratory inhibition happened in the patients in group A.Conclusion Because of the stable respiratory and circulatory system,awaking up in time and less untoward effects,anesthesia with propofol and remifentanil with tracheal intubation is safe and manageable in burn surgery.