title: Tracheal intubation in intellectually disabled patients: clinical usefulness of remifentanil and sevoflurane without a muscle relaxant.
abstract: OBJECTIVE
  To compare two remifentanil doses (1 µg/kg and 2 µg/kg) in order to determine the preferred dose in intellectually disabled patients undergoing day care dental surgery under sevoflurane-induced general anaesthesia.
  
  
  METHODS
  Patients were randomly assigned to receive either 1 µg/kg (group 1) or 2 µg/kg (group 2) remifentanil; both groups received 8% sevoflurane anaesthesia induction. All other conditions were identical in both groups. Heart rate (HR), mean arterial pressure (MAP) and intubation conditions were assessed.
  
  
  RESULTS
  A total of 27/30 (90.0%) patients in group 1 and 29/30 patients (96.7%) in group 2 had acceptable intubation conditions. Remifentanil administration resulted in significant reductions in HR compared with baseline levels, in both groups. There were no significant between-group differences in HR at any timepoint. MAP decreased significantly compared with baseline in group 2 only.
  
  
  CONCLUSIONS
  Successful tracheal intubation in intellectually disabled patients can be accomplished with a combination of 1 µg/kg or 2 µg/kg remifentanil and 8% sevoflurane anaesthesia induction, without the requirement for neuromuscular blocking drugs.
authors.affiliation: Department of Anaesthesia and Reanimation, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Cagiran
authors.forename: Can
authors.initials: C
authors.lastname: Eyigor
authors.forename: Taner
authors.initials: T
authors.lastname: Balcioglu
authors.forename: Meltem
authors.initials: M
authors.lastname: Uyar
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid; D000766:Anesthesia, Dental; D018685:Anesthetics, Inhalation; D062186:Arterial Pressure / Q000187:drug effects; D002648:Child; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008607:Intellectual Disability / Q000601:surgery*; D007442:Intubation, Intratracheal; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D010880:Piperidines / Q000008:administration & dosage*; D000077208:Remifentanil; D000077149:Sevoflurane
chemical_list: D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D004338:Drug Combinations; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil
keywords: Remifentanil; day care surgery; endotracheal intubation; neuromuscular block