Tracheal Intubation without Muscle Relaxant – the
Impact of Different Sufentanil Doses on the Quality of Intubating Conditions: A Prospective Study
1Adamus M., 1Koutná J., 1Gabrhelík T., 2Zapletalová J.
1Klinika anesteziologie a resuscitace LF UP a FN, Olomouc 2Ústav lékařské biofyziky LF UP, Olomouc |
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Summary:
Background. Following opioid and intravenous anaesthetic, tracheal intubation may be accomplished
without any muscle relaxant. In this study, we evaluated the dose requirements for sufentanil with propofol
without muscle relaxant administration to obtain clinically acceptable intubation conditions and
cardiovascular responses.
Methods and Results. After midazolam (0.05 mg.kg-1), 90 patients were randomized into three equal
groups, each receiving sufentanil 0.2 (SUF-0.2), 0.3 (SUF-0.3) or 0.4 (SUF-0.4) μg.kg-1, respectively.
Following induction of anaesthesia with propofol (2 mg.kg-1), the quality of tracheal intubation was
assessed as excellent or good (clinically acceptable) and poor. Excellent intubation conditions were
observed in 28 %, 41 % and 54 % of patients in groups SUF-0.2, SUF-0.3 and SUF-0.4, respectively,
while poor conditions were present in 31 % (SUF-0.2; p = 0.041 vs. SUF-0.3, p = 0.006 vs SUF-0.4),
7 % (SUF-0.3) and 3 % (SUF-0.4). Patients with induction-related hypotension were older than those
without (60 ± 15 vs. 52 ± 17 yr, p = 0.013).
Conclusions. Sufentanil (0.3–0.4 μg.kg-1) in combination with propofol (2 mg.kg-1) provided clinically
acceptable intubating conditions in 93–97% patients.
Key words:
general anaesthesia, endotracheal intubation, propofol, sufentanil
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