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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