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目的：探讨丙泊酚复合瑞芬太尼用于无肌松药气管插管的最佳剂量，评估诱导期应用此种方法的有效性。方法：择期全麻的患者100 例，ASAⅠ～Ⅱ级，随机分为三组。麻醉诱导为丙泊酚2 mg/kg，瑞芬太尼为2 ug/kg（Ⅰ组）、3 ug/kg（Ⅱ组）和4 ug/kg（Ⅲ 组），待两种药物达到药效高峰时行气管插管。观察诱导期和插管后1 min，3 min 的血流动力学的变化情况，评估插管满意度。结果：各组的插管满意度如下：Ⅰ组54.2%(19/35) 、Ⅱ组83.3%(25/30) 、Ⅲ组97.1%（34/35），随着瑞芬太尼剂量的增加，气管插管满意度增高，气管插管操作时间缩短（P＜0.05）。在诱导过程中，三组患者的MAP和HR 下降幅度均较显著（P＜0.05）。结论：丙泊酚复合瑞芬太尼用于无肌松药气管插管是可行的，与复合瑞芬太尼2 ug/kg 或3 ug/kg 相比，丙泊酚2 mg/kg复合瑞芬太尼4 ug/kg 能明显提供更好的气管插管条件，且插管操作时间明显缩短。

英文摘要:

Objective:We aimed to evaluate the security and effectiveness of intubation with propofol and remifentanil without neuromuscular blockade, to compare intubation condition followed varying dose of remifentanil and to investigate the optimization dosage.Methods:100 patients were randomly divided into 3 groups: propofol 2 mg/kg, remifentanil 2 ug/kg (Group Ⅰ), remifentanil 3 ug/kg (Group Ⅱ), and remifentanil 4 ug/kg (Group Ⅲ ) respectively. Ninety seconds after the administration, tracheal intubation were attempted. Intubation condition and hemodynamic changes after hypnotic agent administration, immediately after tracheal intubation, 1 and 3 minutes after intubation were observed.Results:Intubation conditions were clinically acceptable in 54.2% in Group Ⅰ compared with 83.3% in Group Ⅱ and 97.1% in Group Ⅲ (P<0.05). MAP and HR at post-induction period were significantly decreased in each group (P<0.05). Intubation time were decreased as remifentanil dose increased.Conclusion:Propofol and remifentanil for intubation without neuromuscular blockade was safe and effective. The best intubating conditions were produced by the combination of propofol 2 mg/kg with remifentanil 4 ug/kg.

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