Remifentanil without muscle relaxants for intubation in microlaryngoscopy: a double blind randomised clinical trial

N. Gulhas, S. Topal, G. Erdogan Kayhan, A. Yucel, Z. Begec, S. Yologlu, M. Durmus, M.O. Ersoy

Department of Anaesthesiology and Reanimation and Department of Biostatistics, School of Medicine, Inonu University, Malatya, Turkey. nurcin.gulhas@inonu.edu.tr

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• Anesthesiology

OBJECTIVES: We aimed to compare the effect of remifentanil without muscle relaxant with succinylcholine for intubation in microlaryngoscopy.

PATIENTS AND METHODS: Eighty patients were randomly divided into two groups: Group R (n=40) and S (n=40) received remifentanil 4 µg/kg intravenously or 1 µg/kg respectively. Anesthesia was induced with 2 mg/kg propofol in both groups. Intubation was performed after bolus administration of 10 ml saline as a placebo or 1 mg/kg of succinylcholine in Group R and S respectively. Remifentanil infusion was initiated at 0.025 μg/kg in each groups.

RESULTS: Intubation conditions were similar in both groups. The mean arterial pressure (MAP) values at post-induction period were significantly lower in the Group S than in the Group R (p = 0.001). The requirement for ephedrine in Group R was found to be significantly lower than Group S (p = 0.023). Recovery times were significantly shorter (p = 0.001) and recovery scores were significantly higher (p = 0.021) in Group R. Time to patient could respond to commands was significantly longer in the Group S (p = 0.001). The surgeon’s satisfaction score was significantly higher in Group R (p = 0.001).

CONCLUSIONS: It was concluded that remifentanil without muscle relaxants provides similar intubating conditions as that provided by succinylcholine, and remifentanil is superior to succinylcholine with regard to haemodynamic stability and recovery duration.

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