Comparison of remifentanil with alfentanil or suxamethonium following propofol anaesthesia for tracheal intubation.
Sixty ASA physical status I and II, premedicated patients were administered propofol 2 mg x kg-1 and remifentanil 2 microg x kg-1 (group R), alfentanil 50 microg x kg-1 (group A) or suxamethonium 1 mg x kg-1 (group S) as a rapid bolus. One minute after study drug administration, tracheal intubation was performed. Intubation conditions were then scored. Excellent or good conditions were observed in only 35% in group R compared with groups S and A (100% and 85%, respectively; p < 0.001). The haemodynamic response to tracheal intubation was blunted in groups R and A compared with group S (p < 0.001). The mean heart rate in groups R and A was significantly lower than group S (p < 0.001). We conclude that remifentanil 2 microg x kg-1 given as a rapid bolus will not produce intubating conditions as good as those obtained with alfentanil 50 microg x kg-1 or suxamethonium 1 mg x kg-1 if administered after propofol 2 mg x kg-1.
Alexander
R
R
Department of Anesthesiology, Box 3094, Duke University Medical Centre, Durham, NC 27710, USA.
Booth
J
J
Olufolabi
A J
AJ
El-Moalem
H E
HE
Glass
P S
PS
D000328:Adult; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D009467:Neuromuscular Depolarizing Agents / Q000494:pharmacology*; D010880:Piperidines / Q000494:pharmacology*; D015742:Propofol / Q000494:pharmacology; D000077208:Remifentanil; D013390:Succinylcholine / Q000494:pharmacology*
D018686:Anesthetics, Intravenous; D009467:Neuromuscular Depolarizing Agents; D010880:Piperidines; D013390:Succinylcholine; D000077208:Remifentanil; D015742:Propofol