title: Are muscle relaxants needed for nasal intubation in propofol and remifentanil anesthesia?
abstract: OBJECTIVE
  The authors hypothesized that a muscle relaxant would have no meaningful difference in intubation conditions during nasal intubation under remifentanil and propofol anesthesia.
  
  
  METHODS
  This parallel-group, double-blinded, randomized controlled trial included 44 patients who received saline (S group; n = 22) or rocuronium (R group; n = 22). In addition to remifentanil 0.5 μg/kg per minute and propofol 5 mg/kg per hour, propofol 0.5 mg/kg was administered until loss of consciousness. Nasal intubation was performed 10 minutes after administration of R or S 0.6 mg/kg. Significant differences in intubation conditions and salivary amylase levels before and after intubation were tested (P < .05).
  
  
  RESULTS
  Vocal cord status (P = .003) and response to intubation or cuff filling (P = .008) were significantly different, but intubation conditions were not. Salivary amylase level was significantly lower with R administration (P = .022). No patient complained of postoperative throat pain and hoarseness.
  
  
  CONCLUSIONS
  Muscle relaxants during nasal intubation performed after bolus administration of propofol 0.9 mg/kg in addition to 10 minutes of remifentanil 0.5 μg/kg per minute plus propofol 5 mg/kg per hour are unnecessary.
authors.affiliation: Staff Physician, Department of Oral and Maxillofacial Surgery, Fuji City Central Hospital, Shizuoka, Japan; Department of Dental Anesthesiology, The Nippon Dental University School of Life Dentistry, Tokyo, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Ide
authors.affiliation: Professor, Department of Dental Anesthesiology, The Nippon Dental University School of Life Dentistry, Tokyo, Japan. Electronic address: katsu.sunada@nifty.com.
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Sunada
authors.affiliation: Department Head, Department of Oral and Maxillofacial Surgery, Fuji City Central Hospital, Shizuoka, Japan; Department of Dental Anesthesiology, The Nippon Dental University School of Life Dentistry, Tokyo, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Katsuyama
mesh_terms: D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D004311:Double-Blind Method; D006801:Humans; D007440:Intubation / Q000379:methods*; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009666:Nose; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D000077208:Remifentanil
chemical_list: D018686:Anesthetics, Intravenous; D009125:Muscle Relaxants, Central; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol