Intubating conditions provided by propofol and alfentanil--acceptable, but not ideal.
BACKGROUND
The use of muscle relaxants to facilitate intubation is associated with several side effects regardless of whether depolarizing or non-depolarizing drugs are used. In the present study we compared the intubating conditions, haemodynamic responses and changes in oxygen saturation following induction with alfentanil and propofol or alfentanil, thiopental and suxamethonium.


METHODS
Eighty patients (ASA I or II) were in a double-blind manner assigned to receive either of the two induction methods. Intubating conditions were assessed on the basis of jaw relaxation, ease of insertion of the endotracheal tube and coughing on intubation. Heart rate, systolic arterial pressure and oxygen saturation were monitored throughout the procedure.


RESULTS
The use of alfentanil and propofol resulted in significantly lower scored intubation points. Systolic arterial pressure decreased and heart rate increased significantly in the alfentanil-thiopental-suxamethonium group as compared to the alfentanil-propofol group. There were no significant changes in oxygen saturation.


CONCLUSIONS
The results show that propofol and alfentanil in combination provides haemodynamic stability and unaltered oxygen saturation but less optimal intubating conditions.
Harsten
A
A
Department of Anesthesiology, Central Hospital, Kristianstad, Sweden.
Gillberg
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D015760:Alfentanil / Q000009:adverse effects; D000758:Anesthesia; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents; D010100:Oxygen / Q000097:blood; D015742:Propofol / Q000009:adverse effects; D013390:Succinylcholine / Q000009:adverse effects; D013874:Thiopental / Q000009:adverse effects
D018686:Anesthetics, Intravenous; D009467:Neuromuscular Depolarizing Agents; D015760:Alfentanil; D013390:Succinylcholine; D013874:Thiopental; D010100:Oxygen; D015742:Propofol