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Anesth Analg 2003;96:1336-1339
© 2003 International Anesthesia Research Society

AMBULATORY ANESTHESIA

Remifentanil With Thiopental for Tracheal Intubation Without Muscle Relaxants

Mahmut Durmus, MD, Gedik Ender, MD, But A. Kadir, MD, Gulhas Nurcin, MD, Ozturk Erdogan, MD, and M. Ozcan Ersoy, MD PhD

Department of Anesthesiology, Inonu University, School of Medicine, Malatya, Turkey

Address correspondence and reprint requests to Mahmut Durmus, MD, Inonu University, School of Medicine, Department of Anesthesiology, Elazig Yolu 13.km, 44069-Malatya, Turkey. Address e-mail to mdurmus{at}inonu.edu.tr

Tracheal intubation may be accomplished with remifentanil and a non-opioid IV anesthetic without a muscle relaxant. In this study, we evaluated in double-blinded, prospective, randomized manner the dose requirements for remifentanil with thiopental without muscle relaxant administration to obtain clinically acceptable intubation conditions and cardiovascular responses. After premedication with midazolam 0.03 mg/kg IV, 105 patients were randomized equally to one of three study groups, each receiving the following: remifentanil 2 µg/kg (Group I), 3 µg/kg (Group II), and 4 µg/kg (Group III). Remifentanil was administered over 30 s, and anesthesia was induced with thiopental 5 mg/kg. Tracheal intubation conditions were assessed by the anesthesiologist performing the intubation as: (a) excellent, (b) satisfactory, (c) fair, and (d) unsatisfactory. There were no statistically significant differences among groups regarding to demographic data. Blood pressure and heart rate did not increase in any group after accomplishing intubation. There was a significant improvement in intubation conditions between Groups I and II, I and III, and II and III (P < 0.001). We conclude that remifentanil 4 µg/kg administered before thiopental 5 mg/kg provided excellent or satisfactory intubation conditions in 94% of patients and prevented cardiovascular responses to intubation.

IMPLICATIONS: We evaluated in a double-blinded manner the dose requirements for remifentanil with thiopental without muscle relaxants for obtaining acceptable intubation condition. Our results show that remifentanil 4 µg/kg administered before thiopental provided excellent or satisfactory intubation condition in 94% of patients.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2003 by the International Anesthesia Research Society.