Effects of anesthesia induction with different methods of infusion of propofol on cardiovascular response in patients with pseudoaneurysms during tracheal intubation

TAN Shi-gang; LU Han-jie; YU Ting; GAN Guo-sheng; SONG Xiao-yang

Abstract：Objective To observe the effect of anesthesia induction with different methods of infusion of propofol on cardiovascular response during endotracheal intubation during interventional therapy in patients with intracranial pseudoaneurysms.Methods Sixty patients with intracranial pseudoaneurysm undergoing interventional therapy were divided into three groups of 20 patients each,i.e.in group A (single intravenous injection of propofol),group B (target-controlled plasma concentration of propofol:4μg/ml) and group C (target-controlled effect site concertration:4μg/ml).All three groups anesthesia were induced by target-controlled infusion of remifentanil (target-controlled plasma concentration was 4 ng/ml) in all the groups.Rocuronium 0.6 mg/kg was injected intravenously after the patient's consciousness disappeared.Tracheal intubation was performed when the bispectral index kept between 40 and 60 for 5 seconds.The mean arterial pressure (MAP) and heart rate (HR) were recorded at the time of entering the operating room (T0),immediately after exposure of the glottis with laryngoscope (T1),immediately after tracheal tube passing through the glottis (T2) and 1 minute (T3),2 minutes (T4) and 3 minutes (T5) after tracheal tube entering the trachea the incidence and correction times of adverse reactions during tracheal intubation were recorded.Results MAP significantly decreased at T1,T2 and T3,HR slowed significantly at T1,T2,T3,T4 and T5 in all the groups (P＜0.05) compared with those at T0.MAP was significantly lower and HR was significantly slower in groups A and C than those in group B at T1 (P＜0.05).The incidences of hypotension and bradycardia and the number of their correction in group B were significantly lower than those in group A (P＜0.05) and the number of correction in group C was significantly lower than that in group A (P＜0.05).The incidence and number of correction of bradycardia in group B were significantly lower than those in group C (P＜0.05).Conclusions The plasma concentration of 4μg/ml propofol as the target-controlled infusion concentration is more suitable for anesthesia induction in patients with intracranial pseudoaneurysms undergoing interventional therapy,and the incidence of the adverse reactions including hypotension and bradycardia is significantly lower.