Endotracheal intubation assisted with propofol and remifentanil without neuromuscular blocker

ABSTRACT

We have assessed intubating conditions and haemodynamic changes in three groups of 30 ASA I or II patients after induction of anaesthesia with propofol 2 mg*kg^-1, remifentanil 0.5 μg*Kgr^-1 and rocuronium 0,6 mg*kg^-1 (group R), propofol 2 mg*kg^-1 and remifentanil 1.5 μg*Kgr^-1 (group F) and propofol 2 mg*kg^-1, remifentanil 1.5 μg*Kgr^-1 and midazolam 0.015 mg*kg^-1 (group M). Tracheal intubation was graded according to ease of ventilation, jaw relaxation, position of the vocal cords, reaction during laryngoscopy and during cuff inflation. Intubation was successful in 100% (group R), 96,6% (group F) and 100% (group M )of patients. Overall intubating conditions were regarded as acceptable in 96,6%, 73,3% and 93,3% of patients, respectively. All three groups had a decrease in arterial pressure after induction but there was no difference between groups and was not regarded as clinically significant. According our results the combination of propofol 2 mg*kg^-1, midazolam 0.015 mg*kg^-1 and remifentanil 1.5 μg*Kgr^-1 without neuromuscular blockade provides acceptable intubating conditions, blunts pressor response to intubation without significant cardiovascular depression.