Tracheal intubation in ambulatory surgery patients: using remifentanil and propofol without muscle relaxants

Anesthesia and Analgesia
J B Stevens, L Wheatley

Abstract

Using alfentanil followed by an anesthetic induction dose of propofol provides adequate conditions for tracheal intubation without neuromuscular relaxants. Remifentanil, which has a clinical onset similar to that of alfentanil, has not been investigated for this indication. Accordingly, 80 ASA physical status I and II premedicated outpatients were randomly assigned to one of four groups (n = 20/group). Remifentanil 1, 2, 3, or 4 micrograms/kg (Groups I-IV, respectively) was infused intravenously over 90 s. Sixty seconds after beginning the remifentanil infusion, propofol 2 mg/kg was infused over 5 s. Ninety seconds after the administration of propofol, laryngoscopy and tracheal intubation were attempted and graded. Clinically acceptable intubating conditions (i.e., jaw relaxed, vocal cords open, and fewer than two coughs in response to intubation) were observed in 35%, 75%, 100%, and 95% of patients in Groups I-IV, respectively. Clinically acceptable intubating conditions were significantly (P < 0.05) less likely to occur in Group I compared with all other groups. Excellent intubating conditions (i.e., vocal cords open, no movement in response to intubation) were observed in 30%, 50%, 80%, 80% of patients in Groups I-IV, respec...Continue Reading

Associated Clinical Trials

Apr 13, 2017·Antonio Romero Berrocal

Citations

Jan 25, 2006·Anaesthesia·A Heard, K Langley
Oct 4, 2006·Current Opinion in Anaesthesiology·O Plattner, M Zimpfer
Oct 5, 2006·Current Opinion in Anaesthesiology·C Meistelman
Sep 16, 2003·Pediatric Emergency Care·Alfred SacchettiMichael Gerardi
Apr 30, 2003·Anesthesiology·Thomas MenckeThomas Fuchs-Buder
Apr 16, 2010·Medicinski pregled·Gordana VlajkovićVesna Bumbasirević
Oct 25, 2003·Anesthesiology·Mohamed NaguibSaleh W Alharby
Jul 20, 2007·Acta Anaesthesiologica Scandinavica·L S Rasmussen, J Viby-Mogensen

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