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The effects of sevoflurane with propofol and remifentanil on tracheal intubation conditions without neuromuscular blocking agents.

Kim WJ, Choi SS, Kim DH, Seo HJ, Suk EH, Ku SW, Park PH - Korean J Anesthesiol (2010)

Bottom Line: Scores for vocal cord position, coughing, and limb movement were significantly better in group II (P < 0.05).Mean blood pressure remained significantly lower than the pre-induction level throughout the investigation in both groups (P < 0.001), but there was no incidence of bradycardia or hypotension requiring treatment.Tracheal intubation without neuromuscular blocking agents can be achieved safely and reliably by adding 7% sevoflurane to propofol (2 mg/kg) and remifentanil (1 microg/kg).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background: Propofol and remifentanil are used for tracheal intubation in the absence of neuromuscular blocking agents. We hypothesized that the addition of sevoflurane to propofol and remifentanil would improve intubation conditions and provide hemodynamic stability.

Methods: Seventy-six patients scheduled for elective surgery were randomly allocated to be ventilated with either 4% (group I) or 7% sevoflurane (group II) after propofol injection (2 mg/kg). All patients received remifentanil (1 microg/kg) 30 seconds after administration of propofol. Ninety seconds after remifentanil was given, laryngoscopy and tracheal intubation were performed. Intubation conditions and hemodynamic changes were evaluated.

Results: The overall incidence of clinically acceptable intubation conditions was significantly higher in group II (92%) than group I (58%) (P = 0.001). Scores for vocal cord position, coughing, and limb movement were significantly better in group II (P < 0.05). Mean blood pressure remained significantly lower than the pre-induction level throughout the investigation in both groups (P < 0.001), but there was no incidence of bradycardia or hypotension requiring treatment.

Conclusions: Tracheal intubation without neuromuscular blocking agents can be achieved safely and reliably by adding 7% sevoflurane to propofol (2 mg/kg) and remifentanil (1 microg/kg).

No MeSH data available.


Related in: MedlinePlus

Changes in heart rate during the study. Data are presented as mean ± SD. T0: before induction, T1: after propofol infusion, T2: after remifentanil infusion, T3-5: every 1 min after intubation for 3 min. *P< 0.05 when compared with T0.
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Figure 2: Changes in heart rate during the study. Data are presented as mean ± SD. T0: before induction, T1: after propofol infusion, T2: after remifentanil infusion, T3-5: every 1 min after intubation for 3 min. *P< 0.05 when compared with T0.

Mentions: Before induction, pre-induction MBP and HR were not significantly different between groups (P > 0.05) (Fig. 1 and 2). MBP remained significantly lower than the pre-induction level in both groups (P < 0.001). HR was unchanged or lower compared with pre-induction levels in both groups, but MBP and HR were not different at any time (P > 0.05). There was no episode of opioid-induced muscle rigidity, bradycardia, or hypotension requiring treatment and no other side effects were seen. SpO2 remained at the pre-induction levels, 97-100%, in all patients.


The effects of sevoflurane with propofol and remifentanil on tracheal intubation conditions without neuromuscular blocking agents.

Kim WJ, Choi SS, Kim DH, Seo HJ, Suk EH, Ku SW, Park PH - Korean J Anesthesiol (2010)

Changes in heart rate during the study. Data are presented as mean ± SD. T0: before induction, T1: after propofol infusion, T2: after remifentanil infusion, T3-5: every 1 min after intubation for 3 min. *P< 0.05 when compared with T0.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2926435&req=5

Figure 2: Changes in heart rate during the study. Data are presented as mean ± SD. T0: before induction, T1: after propofol infusion, T2: after remifentanil infusion, T3-5: every 1 min after intubation for 3 min. *P< 0.05 when compared with T0.
Mentions: Before induction, pre-induction MBP and HR were not significantly different between groups (P > 0.05) (Fig. 1 and 2). MBP remained significantly lower than the pre-induction level in both groups (P < 0.001). HR was unchanged or lower compared with pre-induction levels in both groups, but MBP and HR were not different at any time (P > 0.05). There was no episode of opioid-induced muscle rigidity, bradycardia, or hypotension requiring treatment and no other side effects were seen. SpO2 remained at the pre-induction levels, 97-100%, in all patients.

Bottom Line: Scores for vocal cord position, coughing, and limb movement were significantly better in group II (P < 0.05).Mean blood pressure remained significantly lower than the pre-induction level throughout the investigation in both groups (P < 0.001), but there was no incidence of bradycardia or hypotension requiring treatment.Tracheal intubation without neuromuscular blocking agents can be achieved safely and reliably by adding 7% sevoflurane to propofol (2 mg/kg) and remifentanil (1 microg/kg).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background: Propofol and remifentanil are used for tracheal intubation in the absence of neuromuscular blocking agents. We hypothesized that the addition of sevoflurane to propofol and remifentanil would improve intubation conditions and provide hemodynamic stability.

Methods: Seventy-six patients scheduled for elective surgery were randomly allocated to be ventilated with either 4% (group I) or 7% sevoflurane (group II) after propofol injection (2 mg/kg). All patients received remifentanil (1 microg/kg) 30 seconds after administration of propofol. Ninety seconds after remifentanil was given, laryngoscopy and tracheal intubation were performed. Intubation conditions and hemodynamic changes were evaluated.

Results: The overall incidence of clinically acceptable intubation conditions was significantly higher in group II (92%) than group I (58%) (P = 0.001). Scores for vocal cord position, coughing, and limb movement were significantly better in group II (P < 0.05). Mean blood pressure remained significantly lower than the pre-induction level throughout the investigation in both groups (P < 0.001), but there was no incidence of bradycardia or hypotension requiring treatment.

Conclusions: Tracheal intubation without neuromuscular blocking agents can be achieved safely and reliably by adding 7% sevoflurane to propofol (2 mg/kg) and remifentanil (1 microg/kg).

No MeSH data available.


Related in: MedlinePlus