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

摘要: BACKGROUND AND OBJECTIVE: In some situations, the use of muscle relaxants (neuromuscular blocking drugs) are undesirable or contraindicated. We compared intubating conditions without in premedicated patients receiving either alfentanil 40 microg kg(-1) remifentanil 2, 3 4 followed by propofol 2 mg kg(-1). METHODS: a randomized, double-blind study, 80 healthy were assigned to one four groups (n = 20). After intravenous atropine, injected over 90 s Ninety seconds after administration propofol, laryngoscopy and tracheal intubation attempted. Intubating assessed as excellent, good poor on basis ease lung ventilation, jaw relaxation, laryngoscopy, position vocal cords, patient response slow inflation endotracheal tube cuff. RESULTS: Seven who received could not be intubated at first attempts. Excellent (jaw relaxed, cords open no movement cuff inflation) observed those (45% patients) doses (20%), (75%) (95%). Overall, significantly better (P < 0.05), number showing excellent higher 0.05) with No needed treatment for hypotension bradycardia. CONCLUSIONS: Remifentanil administered sequence intravenously provided all relaxants.