A comparison of intubating conditions in children following induction of anaesthesia with propofol and suxamethonium or propofol and remifentanil.
Sixty ASA 1 and 2 children aged between 2 and 16 years who required tracheal intubation as part of anaesthesia for elective surgery were studied. We evaluated intubating conditions, haemodynamic responses and duration of apnoea following propofol 4 mg.kg-1 combined with either remifentanil 1.25 microg.kg-1 (group R), or suxamethonium 1 mg.kg-1 (group S). Tracheal intubation was graded as excellent, good or poor according to ease of laryngoscopy, vocal cord position, coughing, and jaw relaxation and limb movement. Thirty of group S and 28 of group R children were successfully intubated on the first attempt. Overall, intubation conditions were excellent or good in 26/30 (87%) patients in group S and 20/30 (67%) in group R (p<0.05). Mean apnoea time was 190 s in group S, and 362 s in group R (p<0.001). Heart rate increased in response to suxamethonium (p<0.01) and both systolic and diastolic blood pressure decreased in the remifentanil group (p<0.01).
Morgan
J M
JM
Department of Anaesthesia, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK.
Barker
I
I
Peacock
J E
JE
Eissa
A
A
D000293:Adolescent; D000701:Analgesics, Opioid / Q000494:pharmacology; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy; D008297:Male; D009467:Neuromuscular Depolarizing Agents / Q000494:pharmacology; D010880:Piperidines / Q000494:pharmacology*; D015742:Propofol / Q000494:pharmacology*; D000077208:Remifentanil; D013390:Succinylcholine / Q000494:pharmacology*
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D009467:Neuromuscular Depolarizing Agents; D010880:Piperidines; D013390:Succinylcholine; D000077208:Remifentanil; D015742:Propofol