This study compares four different anesthesia induction regimens to see which one provides the most stable blood pressure and heart rate during rapid sequence intubation. A total of 172 patients undergoing elective surgery will receive one of four combinations of propofol and opioids (alfentanil or sufentanil). The main outcomes are hypotension (low blood pressure), inadequate blunting of the stress response to intubation, and intubating conditions. The study aims to determine whether a lower dose of propofol combined with a higher dose of alfentanil can improve hemodynamic stability without compromising the quality of tracheal intubation.
Inclusion Criteria:
Exclusion Criteria:
The anesthesia nurse who assessed intubating conditions (Steyn modified Helbo-Hansen score) was blinded to the group allocation. Hemodynamic data were collected by a separate research nurse who was not involved in clinical management or subsequent data analysis.
Propofol 1 mg/kg + Alfentanil 50 μg/kg + Rocuronium 0.6 mg/kg. Propofol administered first, followed by alfentanil over 10 seconds, then rocuronium. Tracheal intubation performed 1 minute after rocuronium.
Propofol 2 mg/kg + Alfentanil 30 μg/kg + Rocuronium 0.6 mg/kg. Same sequence as Group A (propofol first, then alfentanil, then rocuronium, intubation at 1 min).
Propofol 2 mg/kg + Sufentanil 0.5 μg/kg + Rocuronium 0.6 mg/kg. Sufentanil given over 30 seconds, followed by 4 minutes of mask ventilation, then propofol and rocuronium. Intubation 1 minute after rocuronium.
Propofol 2 mg/kg + Alfentanil 50 μg/kg + Rocuronium 0.6 mg/kg. Same sequence as Group A (propofol first, then alfentanil, then rocuronium, intubation at 1 min).
Zhangjiagang, Jiangsu 215600, China
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