Tracheal Intubation without Muscle Relaxant : a Comparison between Fentanyl-Lidocaine-Propofol and Fentanyy-Propofol-Succinylcholine, a Preliminary Report
Anantachoty Y, Iamaroon A*, Mandee S, Puangchan S, Surachetpong S, Tangwiwat S
Department of Anesthesiology, Faculty of medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
To assess intubating conditions after administration of fentanyl-lidocaine-propofol compared with fentanyl-propofol-succinylcholine, 80 ASA I or II patients were randomized into two groups. All patients received midazolam 0.05 mg/kg IV before induction. The control group received atracurium 0.06 mg/kg, fentanyl 1.5 ug/kg, 0.9% normal saline (NSS), propofol 2 mg/kg, and succinylcholine 1.5 mg/kg IV. The study group received NSS, fentanyl 3 ug/kg, lidocaine 1.5 mg/kg propofol 2.5 mg/kg and NSS IV. Intubating conditions were graded according to jaw relaxation, ease of ventilation, vocal exposure, vocal cord position and patient responses. Intubating conditions were judged acceptable, when all scores were excellent or good. If any of the scores was poor. Intubating conditions were judged unacceptable. Hemodynamic response to tracheal intubation was recorded. Intubation was successful in all patients and there were no differences in ease of ventilation, exposure of vacal cords, cord position or patient responses. Jaw relaxation was more relaxed in the study group (87.5%) than in the control group (65%), P = 0.013. Excellent intubating conditions were observed in 52.5% and 57.5% of patients in the control and study group, respectively. All patients in the study group had acceptable intubating conditions, compared with 38 of 40 patients (95%) in the control group. However, there was no significant difference between groups (P=0.49). Mean arterial pressure in the study group was greater decreased than the control group after induction and intubation. We conclude that tracheal intubation using fentanyl-lidocaine-propofol may be an alterantive to tracheal intubation with fentanyl-propofol-succinylcholine.  
วิสัญญีสาร ปี 2548, April-June ปีที่: 31 ฉบับที่ 2 หน้า
tracheal intubation, without muscle relaxant