Tracheal intubation without muscle relaxants: remifentanil or alfentanil in combination with propofol

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dc.contributor.authorErhan, E
dc.contributor.authorUgur, G
dc.contributor.authorAlper, I
dc.contributor.authorGunusen, I
dc.contributor.authorOzyar, B
dc.date.accessioned2019-10-27T19:02:27Z
dc.date.available2019-10-27T19:02:27Z
dc.date.issued2003
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground and objective: In some situations, the use of muscle relaxants (neuromuscular blocking drugs) are undesirable or contraindicated. We compared intubating conditions without muscle relaxants in premedicated patients receiving either alfentanil 40 mug kg(-1) or remifentanil 2, 3 or 4 mug kg(-1) followed by propofol 2 mg kg(-1). Methods: In a randomized, double-blind study, 80 healthy patients were assigned to one of four groups (n = 20). After intravenous atropine, alfentanil 40 mug kg(-1) or remifentanil 2, 3 or 4 mug kg(-1) were injected over 90 s followed by propofol 2 mg kg(-1). Ninety seconds after administration of the propofol, laryngoscopy and tracheal intubation were attempted. Intubating conditions were assessed as excellent, good or poor on the basis of ease of lung ventilation, jaw relaxation, laryngoscopy, position of the vocal cords, and patient response to intubation and slow inflation of the endotracheal tube cuff. Results: Seven patients who received remifentanil 2 mug kg(-1) and one patient who received remifentanil 3 mug kg(-1) could not be intubated at the first attempts. Excellent intubating conditions (jaw relaxed, vocal cords open and no movement in response to tracheal intubation and cuff inflation) were observed in those who received either alfentanil 40 mug kg(-1) (45% of patients) or remifentanil in doses of 2 mug kg(-1) (20%), 3 mug kg(-1) (75%) or 4 mug kg(-1) (95%). Overall, intubating conditions were significantly better (P < 0.05), and the number of patients showing excellent conditions were significantly higher (P < 0.05) in patients who received remifentanil 4 mug kg(-1) compared with those who received alfentanil 40 mug kg(-1) or remifentanil 2 mug kg(-1). No patient needed treatment for hypotension or bradycardia. Conclusions: Remifentanil 4 mug kg(-1) and propofol 2 mg kg(-1) administered in sequence intravenously provided good or excellent conditions for tracheal intubation in all patients without the use of muscle relaxants.en_US
dc.identifier.doi10.1097/00003643-200301000-00007en_US
dc.identifier.endpage43en_US
dc.identifier.issn0265-0215
dc.identifier.issue1en_US
dc.identifier.pmid12557834en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage37en_US
dc.identifier.urihttps://doi.org/10.1097/00003643-200301000-00007
dc.identifier.urihttps://hdl.handle.net/11454/38013
dc.identifier.volume20en_US
dc.identifier.wosWOS:000180664000007en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherGreenwich Medical Media Ltden_US
dc.relation.ispartofEuropean Journal of Anaesthesiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectanaesthesia, intratrachealen_US
dc.subjectanaesthetics, intravenous, propofol, remifentanilen_US
dc.subjectalfentanilen_US
dc.titleTracheal intubation without muscle relaxants: remifentanil or alfentanil in combination with propofolen_US
dc.typeArticleen_US

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