title: TCI remifentanil vs. TCI propofol for awake fiber-optic intubation with limited topical anesthesia.
abstract: The purpose of this study was to compare the effects of propofol and remifentanil target-controlled infusion (TCI) on awake fiber-optic intubation with limited local anesthesia. 36 patients requiring fiberoptic intubation were randomized to receive propofol (P) or remifentanil (R) effect-site TCI. Target concentrations, sedation levels, pulse oximetry, hemodynamic change, duration, number of adjustments, intubating conditions and recall after surgery were recorded at each stage. The results showed that the target intubation concentration of remifentanil was very close to the sedation concentration but that the intubation concentration of propofol was more than double its sedation concentration (5.83±1.46 μg/ml vs. 2.60±0.47 μg/ml, respectively). Vocal cord opening was significantly better in remifentanil-treated patients. More adjustments and a longer duration were required in propofol-treated patients. Recall was significantly more frequent in remifentanil-treated patients. We concluded that compared to TCI propofol, TCI remifentanil can provide safer and better intubating conditions for fiber-optic intubation with limited local anesthesia.
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
authors.forename: Xuyu
authors.initials: X
authors.lastname: Zhang
authors.forename: Wen
authors.initials: W
authors.lastname: He
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Wu
authors.forename: Xue
authors.initials: X
authors.lastname: Zhou
authors.forename: Wenqi
authors.initials: W
authors.lastname: Huang
authors.forename: Xia
authors.initials: X
authors.lastname: Feng
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D007262:Infusions, Intravenous; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000077208:Remifentanil; D013997:Time Factors; D014827:Vocal Cords
chemical_list: D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol