The effect of additional propofol on intubation conditions

Kwon, Min Soo; Kim, Seok K.; Jeon, Dae‐Geun; Song, Jae Kwan; Kim, Won I.

doi:10.1016/j.jclinane.2010.05.004

Cited by 5 publications

(6 citation statements)

References 14 publications

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“…Propofol is another anesthetic drug administered via the intravenous route. An additional dose of propofol (0.5 mg kg − 1 ) before intubation can significantly improve intubation conditions without increasing hypotension risk [ 12 ]. However, a study focusing on administration of lidocaine combined with a low dose of propofol to prevent the stress response, and whether it is non-inferior to dexmedetomidine use in facilitating adequate control of hemodynamics during laryngoscopy and intubation, has not been done.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the hemodynamic response of dexmedetomidine versus additional intravenous lidocaine with propofol during tracheal intubation: a randomized controlled study

et al. 2021

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Background Laryngoscopy and tracheal intubation are strong stimuli that cause a reflex increase in blood pressure (BP), heart rate (HR), and serum catecholamine level. These can lead to myocardial infarction or cerebrovascular accidents. The purpose of this study is to compare the efficacy of dexmedetomidine and lidocaine combined with propofol in attenuating the hemodynamic response following laryngoscopy and endotracheal intubation. Methods This study was a randomized controlled study and adhered to the CONSORT guidelines. One-hundred and six patients undergoing elective general anesthesia with endotracheal intubation were divided randomly into two groups. Group D received dexmedetomidine (1 μg kg− 1) before induction. Group LP received lidocaine (1.5 mg kg− 1) before induction with additional propofol (0.5 mg kg− 1) before laryngoscopy. The primary endpoint was hemodynamic including systolic (S) BP, diastolic (D) BP, mean arterial blood pressure (MAP) and HR measured before and after induction and ≤ 10 min after intubation. Secondary outcome was complications/adverse effects. Results After induction, the mean SBP, DBP, MAP and HR decreased significantly from baseline in both groups except for mean HR in group LP at 1 min. Differences in mean values of SBP, DBP, and MAP were significantly lower in group D after intubation at 4–10 min (P < 0.05). Group LP had a non-inferior effect in blunting BP at all time points except 1 and 2 min after induction, and 2 min after intubation. The mean difference in HR in group D was significantly lower than that in group LP at all time points (P < 0.001). Group D had significantly more episodes of bradycardia (18.87% vs. 0%, P = 0.001) and hypotension (52.83% vs. 15.09%, P < 0.001) than did group LP. Conclusion Lidocaine (1.5 mg kg− 1) with additional propofol (0.5 mg kg− 1) had a non-inferior effect compared with dexmedetomidine (1 μg kg− 1) in attenuating the hemodynamic response following laryngoscopy and endotracheal intubation, and had fewer adverse effects. Trial registration Thai Clinical Trial Registry, (TRTC20190206002). Retrospectively registered 4 February 2019.

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Section: Introductionmentioning

confidence: 99%

Comparison of the hemodynamic response of dexmedetomidine versus additional intravenous lidocaine with propofol during tracheal intubation: a randomized controlled study

et al. 2021

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“…Kwon et al . [3] showed that the administration of additional dose of propofol (0.5 mg/kg) prior to intubation may improve intubation conditions significantly without inducing hypotension. They found that adding a booster of propofol, increases it's plasma concentration at intubation, thus it might augment intubation conditions.…”

Section: Discussionmentioning

confidence: 99%

“…[2] Kwon et al . [3] showed that the administration of additional dose of propofol (0.5 mg/kg) prior to intubation may improve intubation conditions significantly without affecting hemodynamic variables. Above study described the effects of only one additional dose of propofol on intubation conditions and that was, as a bolus.…”

Section: Introductionmentioning

confidence: 99%

Comparing the effects of three different additional doses of propofol infusion on intubation condition and hemodynamic changes during general anesthesia under elective surgery: A randomized, placebo-controlled, double blind clinical trial

2014

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Background:Laryngoscopy and endotracheal intubation can induce unfavorable hemodynamic changes as propofol itself can induce hypotension. The aim of this study was to compare the effects of three different additional doses of propofol infusion on intubation conditions and hemodynamic changes occurred after intubation.Materials and Methods:This double-blinded prospective study was performed on 140 patients aged 18-60 who received different additional doses of propofol and were randomly allocated into 4 groups as follows: A: Received additional dose of propofol 0.5 mg/kg infused after an initial dose 1.5 mg/kg. B: Received additional dose of propofol 1 mg/kg infused after an initial dose 1 mg/kg. C: Received additional dose of propofol 1.5 mg/kg after an initial dose 1 mg/kg. D: Received propofol 2 mg/kg as a bolus with no additional dose.Results:Intubation conditions were acceptable in 91.4% of Group A patients, 94.2% of Group B patients, 97.1% of Group C patients and 68.5% of Group D patients. There were no significant differences in the mean of heart rate between four groups at any time before and after laryngoscopy. Mean arterial pressure (MAP) 3 min after laryngoscopy was significantly lower in Group D versus Group A (P = 0.015) while MAP was not different at any time between other groups.Conclusion:Infusion of propofol 1.5 mg/kg added to initial bolus dose of propofol 1 mg/kg improves intubation conditions significantly without inducing hemodynamic changes.

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“…An acceleration transducer was mounted on the thumb and the hand was plastered on the operation table with leaving the thumb free. Patients were covered fully and it was ensured that the thenar region skin temperature did not fall below 32 o C. 9 The surgery room temperature was set to 20- Prior to induction, 10 ml.kg -1 ringer lactate infusion was initiated. The patients were divided into two groups according to ''Random Samples Table''.…”

Section: Ethicsmentioning

confidence: 99%

“…7,8 Propofol is found to be effective in improvement of intubation conditions. 9 A combination of a subhypnotic dose of ketamine with propofol during induction may be advantageous for additional good intubation success and prevention of hypotension and bradicardia due to propofol. We hypothesized that combining ketamine in a subhypnotic dose with propofol during induction might shorten the onset time of rocuronium and improve the intubation conditions of rocuronium block with an advantage of preventing the hypotensive effect of propofol.…”

mentioning

confidence: 99%

The Effects of a Subhypnotic Dose of Ketamine on Neuromuscular Block Characteristics of Rocuronium and Intubation Quality

Abduşoğlu¹,

Turan²,

Yurtlu³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T OOb bj je ec ct ti iv ve e: : In this study, we aimed to examine the effects of a subhypnotic dose of ketamine on the neuromuscular block characteristics of rocuronium and intubation quality. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Sixty patients in ASA I-II risk group were included in the study. Group S received 5 mL of 0.9% saline and Group K received 0.5 mg.kg -1 ketamine in 5 mL volume, one minute before induction. Both groups had anesthesia induction with a propofol dose of 2.5 mg.kg -1 (Propofol 1%, Fresenius Kabi). This was considered as anesthesia start time. After 1 min, a control single twitch stimulus (0.1 Hz) was applied and recorded. All patients were given 0.6 mg.kg -1 rocuronium (Esmeron ® 50 mg.5 ml -1 N.V. Organon, Oss, Holland) in 5 sec. When the single twitch response was depressed 100%, the patient was intubated and the full depression time (onset time) was noted. Anesthesia maintenance was achieved with O 2 /N 2 O and sevoflurane. Following the intubation, the application of train-of -four (TOF) stimulation was started. When the TOF ratio reached to 20%, rocuronium was repeated at a dose of 0.2 mg.kg . Clinical duration (T25), recovery index (T25-75) and spontaneous recovery time to TOF > 0.9 were recorded. Intubation conditions were assessed by using the scale of Fuchs-Buder. The additional drugs used during the operation and neuromuscular blocker amounts were recorded. The hemodynamic values of both groups were recorded throughout the study. Postoperative recovery times, visual analogue pain scores (VAS) and Ramsay sedation scores were also recorded. R Re es su ul lt ts s: : The time for 100% depression of single twitch in Group K was shorter than that of Group S (p<0.05). The clinical duration, recovery index and spontaneous recovery duration of the first dose of rocuronium were longer in Group K compared to Group S (p<0.05). There was no difference between the total neuromuscular blocker amounts of the study groups. There was no significant difference between the groups according to intubation scores (p>0.05), recovery times (p>0.05), VAS scores, Ramsay sedation scores or mean arterial pressure values. When the mean heart rate values of the groups were compared, all values of Group K were higher than those of Group S except control and 60 th min values (p<0.001). C Co on nc cl lu us si io on n: : According to our findings, ketamine in a subhypnotic dose shortens the onset time of rocuronium block and extends the clinical duration of first dose of rocuronium without improving the intubation quality.K Ke ey y W Wo or rd ds s: : Ketamine; propofol; rocuronium Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada subhipnotik doz ketaminin rokuronyumun nöromusküler blok özellikleri ve entübasyon kalitesi üzerindeki etkilerini incelemeyi amaçladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : ASA I-II risk grubundaki 60 hasta çalışmaya alındı. Grup S'ye 5 mL %0,9 serum fizyolojik verildi, Grup K'ya indüksiyondan bir dakika önce 5 mL 0,5 mg.kg -1 ketami...

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The effect of additional propofol on intubation conditions

Cited by 5 publications

References 14 publications

Comparison of the hemodynamic response of dexmedetomidine versus additional intravenous lidocaine with propofol during tracheal intubation: a randomized controlled study

Comparison of the hemodynamic response of dexmedetomidine versus additional intravenous lidocaine with propofol during tracheal intubation: a randomized controlled study

Comparing the effects of three different additional doses of propofol infusion on intubation condition and hemodynamic changes during general anesthesia under elective surgery: A randomized, placebo-controlled, double blind clinical trial

The Effects of a Subhypnotic Dose of Ketamine on Neuromuscular Block Characteristics of Rocuronium and Intubation Quality

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