Propofol — not thiopental or etomidate — with remifentanil provides adequate intubating conditions in the absence of neuromuscular blockade

Erhan, Elvan; Ugur, G.; Günüşen, İlkben; Alper, Işık; Ozyar, B.

doi:10.1007/bf03017840

Cited by 103 publications

(66 citation statements)

References 22 publications

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“…However, in some situations, e. g. , a full stomach, difficult intubation, and certain neuromuscular diseases, the administration of these agents is considered controversial. Therefore, other agents and methods, such as opioid agents, intravenous (propofol instead of thiopental) or inhaled (sevofluran) hypnotics can be usedin such situations to facilitate endotracheal intubation (1)(2)(3)(4). Opioids are agents that suppress respiration in addition to providing appropriate conditions for endotracheal intubation; they are therefore good substitutes for muscle relaxants when used along with intravenous or inhaled hypnotics during intubation (1,2).…”

Section: Introductionmentioning

confidence: 99%

Use of Remifentanil and Alfentanil in Endotracheal Intubation: A Comparative Study

Imani¹,

Faiz²,

Alebouyeh³

et al. 2011

Anesth Pain

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A B S T R A C TBackground: Opioids, such as alfentanil, are used to facilitate endotracheal intubation without the use of neuromuscular blocking agents in patients undergoing elective surgery. Objectives: The goal of this study was to evaluate the endotracheal intubation conditions when remifentanil or alfentanil was used with propofol without the application of neuromuscular blocking agents. Patients and Methods: One hundred American Society of Anesthesiologists (ASA) grade I patients scheduled for elective surgery were enrolled in this prospective, randomized, triple-blinded study. The patients were randomized to group A (alfentanil) or R (remifentanil). In group A, alfentanil (50 mcg/kg) was intravenously injected over 10 seconds, and after 45 seconds or at the occurrence of apnea, propofol (2 mg/kg) was intravenously injected over 5 seconds. Thirty seconds after the administration of propofol, laryngoscopy and endotracheal intubation were attempted. In group R, remifentanil (5 mcg/kg) was administered instead of alfentanil. Intubation conditions, including ease of laryngoscopy, patency of the vocal cords, jaw relaxation, limb movement (1-4 score), and also, demographic data were evaluated. Results: There were no demographic data diffrerences between groups (age, weight, and sex). Further, laryngoscopy, jaw relaxation, and limb movement scores were similar in the R and A groups and there were no significant differences, but vocal cords were significantly more patent in group R than those in group A (P = 0. 028). Conclusions:The results of this study showed that remifentanil, similar to alfentanil, provided excellent conditions for endotracheal intubation when used with propofol for the induction of anesthesia; however, remifentanil improved the patency of the vocal cords to a greater extent than alfentanil.

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Section: Introductionmentioning

confidence: 99%

Use of Remifentanil and Alfentanil in Endotracheal Intubation: A Comparative Study

Imani¹,

Faiz²,

Alebouyeh³

et al. 2011

Anesth Pain

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“…Total intravenous anesthesia in children, with manual-or target-controlled infusion, became more widespread with the advent of short latency drugs, with fast arousal, absence of cumulative effects, and ease of titration 12 . The coadministration of propofol and the ultrashort-acting opioid, remifentanil, has been used in children to facilitate tracheal intubation without neuromuscular blockade in elective surgeries 13,14 . When comparing the dose-response of remifentanil for intubation of healthy term infants (2-12 months) and children (1-6 years), Crawford et al determined the ED 98 as 2.88 µg.kg -1 and ED 50 of 1.7 µg.kg -1 with 3 mg.kg -1 of propofol -1 .…”

Section: Discussionmentioning

confidence: 99%

Anestesia venosa total (AVT) em lactente com doença de Werdnig-Hoffmann: relato de caso

Resende¹,

Silva²,

Nascimento³

et al. 2010

Rev. Bras. Anestesiol.

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“…11 Finally, first-generation SADs were developed during the era of propofol, a drug with extremely beneficial effects on the upper airway reflexes in comparison to alternatives such as barbiturates. [12][13][14] With widespread use, it became clear that new designs were needed to deal with emerging problems and failures being reported. This quest for improved SADs first resulted in the invention of several devices with the ability to accommodate suction or nasogastric tubes.…”

Section: Evolution Of the Supraglottic Airway Devicementioning

confidence: 99%

Supraglottic Airway DevicesDiscussion

Ramachandran

Kumar

2014

Respir Care

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SummarySupraglottic airway devices (SADs) are used to keep the upper airway open to provide unobstructed ventilation. Early (first-generation) SADs rapidly replaced endotracheal intubation and face masks in > 40% of general anesthesia cases due to their versatility and ease of use. Second-generation devices have further improved efficacy and utility by incorporating design changes. Individual second-generation SADs have allowed more dependable positive-pressure ventilation, are made of disposable materials, have integrated bite blocks, are better able to act as conduits for tracheal tube placement, and have reduced risk of pulmonary aspiration of gastric contents. SADs now provide successful rescue ventilation in > 90% of patients in whom mask ventilation or tracheal intubation is found to be impossible. However, some concerns with these devices remain, including failing to adequately ventilate, causing airway damage, and increasing the likelihood of pulmonary aspiration of gastric contents. Careful patient selection and excellent technical skills are necessary for successful use of these devices.

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Propofol — not thiopental or etomidate — with remifentanil provides adequate intubating conditions in the absence of neuromuscular blockade

Abstract: Propofol 2 mg x kg(-1) was superior to thiopentone 6 mg x kg(-1) and etomidate 0.3 mg x kg(-1) for tracheal intubation when combined with remifentanil 3 microg x kg(-1) and no muscle relaxant.

Cited by 103 publications

References 22 publications

Use of Remifentanil and Alfentanil in Endotracheal Intubation: A Comparative Study

Use of Remifentanil and Alfentanil in Endotracheal Intubation: A Comparative Study

Anestesia venosa total (AVT) em lactente com doença de Werdnig-Hoffmann: relato de caso

Supraglottic Airway DevicesDiscussion

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