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Effectiveness of sevoflurane or propofol combined with remifentanil for intubation without muscle relaxants

Year 2011, Volume: 2 Issue: 2, 138 - 143, 01.06.2011
https://doi.org/10.5799/ahinjs.01.2011.02.0227

Abstract

Objectives: We aimed to investigate the reliability of the hypothesis that whether sevoflurane-remifentanil could offer equivalent intubation conditions with propofol-remifentanil in the absence of muscle relaxants. Materials and methods: Total of 80 patients of ASA grades I and II scheduled for elective surgery were randomly allocated into two groups. Patients in group I received an infusion of remifentanil 1 mcg/kg/min and inhalation of sevoflurane 8% until the Bispectral index (BIS) being less than 60. Patients in group II received a co-infusion of remifentanil and propofol 1 mg/kg/h until BIS is

References

  • Stevens JB, Wheatley L. Tracheal intubation in ambulatory surgery patients: using remifentanil and propofol without muscle relaxants. Anesth Analg 1998;86(1):45-9.
  • Collins L, Prentice J, Vaghadia H. Tracheal intubation of out- patients with and without muscle relaxants. Can J Anesth 2000;47(5):427-32.
  • Klemola UM, Mennander S, Saarnivaara L. Tracheal intuba- tion without the use of muscle relaxants: remifentanil or alfentanil in combination with propofol. Acta Anaesthesiol Scand 2000;44(4):465-9.
  • Saarnivaara L, Klemola UM. Injection pain, intubating con- ditions and cardiovascular changes following induction of anaesthesia with propofol alone or in combination with al- fentanil. Acta Anaesthesiol Scand 1991;35(1):19-23.
  • Politis GD, Tobin JR, Morell RC, James RL, Cantwell MF. Tracheal intubation of healthy pediatric patients without muscle relaxant: a survey of technique utilization and per- ceptions of safety. Anesth Analg 1999;88(4):737-4.
  • Politis GD, Frankland MJ, James RL, Reville JF, Rieker MP, Petree BC. Factors associated with successful tracheal intu- bation of children with sevoflurane and no muscle relaxant. Anesth Analg 2002;95(3):615-20.
  • Simon L, Boucebci KJ, Orliaquet G, Aubineau JV, Devys JM, Dubousset AM. A survey of practice of tracheal intuba- tion without muscle relaxant in paediatric patients. Paediatr Anesth 2002;12(1):36-42.
  • Muzi M, Robinson BJ, Ebert TJ, O’Brien TJ. Induction of an- esthesia and tracheal intubation with sevoflurane in adults. Anesthesiology 1996;85(3):536-43.
  • Joo Hs, Perks WJ, Belo SE. Sevoflurane with remifentanil allows rapid tracheal intubation without neuromuscular blocking agents. Can J Anesth 2001;48(7):646-50.
  • Erhan E, Ugur G, Alper I, Gunusen I, Ozyar B. Tracheal intubation without muscle relaxants: remifentanil or al- fentanil in combination with propofol. Eur J Anaesthesiol 2003;20(1):37-43.
  • Taha S, Siddik-Sayyid S, Alameddine M, et al. Propofol is superior to thiopental for intubation without muscle relax- ants. Can J Anesth 2005;52(3):249-53.
  • Hanna S, Ahmad F, Pappas AL, et al. The effect of propofol/remifentanil rapid-induction technique without muscle relaxants on intraocular pressure. J Clin Anesth 2010;22(3):437-42.
  • McKeating K, Bali IM, Dundee JW. The effects of thiopen- thone and propofol on upper airway integrity. Anaesthesia 1988;43(5):638-40.
  • Cros AM, Lopez C, Kandel T, Sztark F. Determination of sevoflurane alveolar concentration for tracheal intubation with remifentanil, and no muscle relaxants. Anaesthesia 2000;55(10):965-9.
  • Kimura T, Watanabe S, Asakura N, Inomata S, Okada M, Taguchi M. Determination of end-tidal sevoflurane concentration for tracheal intubation and minimum al- veolar anesthetic concentration in adults. Anesth Analg 1994;79(3):378-81.
  • Trabold F, Casetta M, Duranteau J, et al. Propofol and re- mifentanil for intubation without muscle relaxant: the ef- fect of the order of injection. Acta Anaesthesiol Scand 2004;48(1):35-9.
  • Thompson JP, Hall AP, Russell J, Caqney B, Rowbotham DJ. Effect of remifentanil on the haemodynamic response to orotracheal intubation. Br J Anesth 1998;80(4):467-9.
  • Sebel PS, Hoke JF, Westmoreland C, Hug CC Jr, Muir KT, Szlam F. Histamine concentrations and hemo- dynamic responses after remifentanil. Anesth Analg 1995;80(7):990-3.
  • Mencke T, Echternach M, Kleinschmidt S, et al. Laringeal morbidity and quality of tracheal intubation. A randomized controlled trial. Anesthesiology 2003;98(9):1049-56.
  • Baillard C, Adnet F, Borron SW, et al. Tracheal intubation in routine practice with and without muscular relaxation: an observational study. Eur J Anaesth 2005;22(6):672-7.
  • Bouvet L, Chassard D, Boselli E. Tracheal intubation with- out muscle relaxants: large doses of opioids, small endotra- cheal tubes. Eur J Anaesthesiol 2006;23(8):712-3.

Kas gevşeticiler olmadan remifentanil ile kombine edilen sevofluran veya propofol ile entübasyonun etkinliği

Year 2011, Volume: 2 Issue: 2, 138 - 143, 01.06.2011
https://doi.org/10.5799/ahinjs.01.2011.02.0227

Abstract

Amaç: Bu çalışmada, kas gevşetici kullanılmadığında, sevofluran-remifentanil kombinasyonunun propofol-remifentanil kombinasyonuna eşdeğer düzeyde entübasyon koşulları sağlayabileceği hipotezinin doğruluğunu araştırmayı amaçladık. Gereç ve yöntem: Elektif cerrahi geçirecek ASA I-II grubundan 80 hasta rastgele iki gruba ayrıldı. Grup I'deki hastalara 1 mcg kg-1 dk-1 remifentanil infüzyonu ile %8 sevofluran inhalasyonu eş zamanlı olarak uygulandı. Grup II'deki hastalara 1mcg kg-1 dk-1 remifentanil ve 1 mg kg-1 dk-1 propofol infüzyonu eş zamanlı olarak uygulandı. Bispektral indeks (BİS) değeri 60'ın altına düşer düşmez entübasyon girişimi uygulandı. Entübasyon koşulları çene gevşemesi, vokal kord açıklığı ve ekstremite hareketi kriterlerine göre optimal, iyi, sınırda ve zayıf olmak üzere değerlendirildi. Kalp hızı ve ortalama arter basıncı indüksiyondan önce, indüksiyon boyunca dakikada bir ve entübasyondan 1, 2 ve 5 dk sonra kaydedildi. BİS değerinin 60'ın altına inmesine kadar geçen süre de kaydedildi. Bulgular: Grup II'de (%90) grup I'e (%45) göre daha yüksek oranda hastada optimal entübasyon koşulları elde edildi (p=0.002). Başarılı entübasyon koşulları oranı grup I'de %80 iken, grup II'de %100 idi (p=0.035). Bispektral indeks değerinin 60'ın altına inmesi için geçen süre grup II'de (47.1±27.2 sn) grup I'e (111.9±60.6 sn) göre daha kısa idi (p=0.000). Kalp hızı ve ortalama arter basıncı her iki grupta da bazal değere göre düşüş gösterdi. Sonuç: Bispektral indeks monitorizasyonu eşliğinde, propofol-remifentanil kombinasyonu sevofluran-remifentanil kombinasyonuna göre daha iyi entübasyon koşulları sağlamış ve anestezi indüksiyonu süresini kısaltmıştır.

References

  • Stevens JB, Wheatley L. Tracheal intubation in ambulatory surgery patients: using remifentanil and propofol without muscle relaxants. Anesth Analg 1998;86(1):45-9.
  • Collins L, Prentice J, Vaghadia H. Tracheal intubation of out- patients with and without muscle relaxants. Can J Anesth 2000;47(5):427-32.
  • Klemola UM, Mennander S, Saarnivaara L. Tracheal intuba- tion without the use of muscle relaxants: remifentanil or alfentanil in combination with propofol. Acta Anaesthesiol Scand 2000;44(4):465-9.
  • Saarnivaara L, Klemola UM. Injection pain, intubating con- ditions and cardiovascular changes following induction of anaesthesia with propofol alone or in combination with al- fentanil. Acta Anaesthesiol Scand 1991;35(1):19-23.
  • Politis GD, Tobin JR, Morell RC, James RL, Cantwell MF. Tracheal intubation of healthy pediatric patients without muscle relaxant: a survey of technique utilization and per- ceptions of safety. Anesth Analg 1999;88(4):737-4.
  • Politis GD, Frankland MJ, James RL, Reville JF, Rieker MP, Petree BC. Factors associated with successful tracheal intu- bation of children with sevoflurane and no muscle relaxant. Anesth Analg 2002;95(3):615-20.
  • Simon L, Boucebci KJ, Orliaquet G, Aubineau JV, Devys JM, Dubousset AM. A survey of practice of tracheal intuba- tion without muscle relaxant in paediatric patients. Paediatr Anesth 2002;12(1):36-42.
  • Muzi M, Robinson BJ, Ebert TJ, O’Brien TJ. Induction of an- esthesia and tracheal intubation with sevoflurane in adults. Anesthesiology 1996;85(3):536-43.
  • Joo Hs, Perks WJ, Belo SE. Sevoflurane with remifentanil allows rapid tracheal intubation without neuromuscular blocking agents. Can J Anesth 2001;48(7):646-50.
  • Erhan E, Ugur G, Alper I, Gunusen I, Ozyar B. Tracheal intubation without muscle relaxants: remifentanil or al- fentanil in combination with propofol. Eur J Anaesthesiol 2003;20(1):37-43.
  • Taha S, Siddik-Sayyid S, Alameddine M, et al. Propofol is superior to thiopental for intubation without muscle relax- ants. Can J Anesth 2005;52(3):249-53.
  • Hanna S, Ahmad F, Pappas AL, et al. The effect of propofol/remifentanil rapid-induction technique without muscle relaxants on intraocular pressure. J Clin Anesth 2010;22(3):437-42.
  • McKeating K, Bali IM, Dundee JW. The effects of thiopen- thone and propofol on upper airway integrity. Anaesthesia 1988;43(5):638-40.
  • Cros AM, Lopez C, Kandel T, Sztark F. Determination of sevoflurane alveolar concentration for tracheal intubation with remifentanil, and no muscle relaxants. Anaesthesia 2000;55(10):965-9.
  • Kimura T, Watanabe S, Asakura N, Inomata S, Okada M, Taguchi M. Determination of end-tidal sevoflurane concentration for tracheal intubation and minimum al- veolar anesthetic concentration in adults. Anesth Analg 1994;79(3):378-81.
  • Trabold F, Casetta M, Duranteau J, et al. Propofol and re- mifentanil for intubation without muscle relaxant: the ef- fect of the order of injection. Acta Anaesthesiol Scand 2004;48(1):35-9.
  • Thompson JP, Hall AP, Russell J, Caqney B, Rowbotham DJ. Effect of remifentanil on the haemodynamic response to orotracheal intubation. Br J Anesth 1998;80(4):467-9.
  • Sebel PS, Hoke JF, Westmoreland C, Hug CC Jr, Muir KT, Szlam F. Histamine concentrations and hemo- dynamic responses after remifentanil. Anesth Analg 1995;80(7):990-3.
  • Mencke T, Echternach M, Kleinschmidt S, et al. Laringeal morbidity and quality of tracheal intubation. A randomized controlled trial. Anesthesiology 2003;98(9):1049-56.
  • Baillard C, Adnet F, Borron SW, et al. Tracheal intubation in routine practice with and without muscular relaxation: an observational study. Eur J Anaesth 2005;22(6):672-7.
  • Bouvet L, Chassard D, Boselli E. Tracheal intubation with- out muscle relaxants: large doses of opioids, small endotra- cheal tubes. Eur J Anaesthesiol 2006;23(8):712-3.
There are 21 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Dilek Karaaslan This is me

Tülay T. Peker This is me

Pakize Kırdemir This is me

Esra Nayır This is me

Özlem Özorak This is me

Hüseyin Kosat This is me

Publication Date June 1, 2011
Published in Issue Year 2011 Volume: 2 Issue: 2

Cite

APA Karaaslan, D., Peker, T. T., Kırdemir, P., Nayır, E., et al. (2011). Kas gevşeticiler olmadan remifentanil ile kombine edilen sevofluran veya propofol ile entübasyonun etkinliği. Journal of Clinical and Experimental Investigations, 2(2), 138-143. https://doi.org/10.5799/ahinjs.01.2011.02.0227
AMA Karaaslan D, Peker TT, Kırdemir P, Nayır E, Özorak Ö, Kosat H. Kas gevşeticiler olmadan remifentanil ile kombine edilen sevofluran veya propofol ile entübasyonun etkinliği. J Clin Exp Invest. June 2011;2(2):138-143. doi:10.5799/ahinjs.01.2011.02.0227
Chicago Karaaslan, Dilek, Tülay T. Peker, Pakize Kırdemir, Esra Nayır, Özlem Özorak, and Hüseyin Kosat. “Kas gevşeticiler Olmadan Remifentanil Ile Kombine Edilen Sevofluran Veya Propofol Ile entübasyonun etkinliği”. Journal of Clinical and Experimental Investigations 2, no. 2 (June 2011): 138-43. https://doi.org/10.5799/ahinjs.01.2011.02.0227.
EndNote Karaaslan D, Peker TT, Kırdemir P, Nayır E, Özorak Ö, Kosat H (June 1, 2011) Kas gevşeticiler olmadan remifentanil ile kombine edilen sevofluran veya propofol ile entübasyonun etkinliği. Journal of Clinical and Experimental Investigations 2 2 138–143.
IEEE D. Karaaslan, T. T. Peker, P. Kırdemir, E. Nayır, Ö. Özorak, and H. Kosat, “Kas gevşeticiler olmadan remifentanil ile kombine edilen sevofluran veya propofol ile entübasyonun etkinliği”, J Clin Exp Invest, vol. 2, no. 2, pp. 138–143, 2011, doi: 10.5799/ahinjs.01.2011.02.0227.
ISNAD Karaaslan, Dilek et al. “Kas gevşeticiler Olmadan Remifentanil Ile Kombine Edilen Sevofluran Veya Propofol Ile entübasyonun etkinliği”. Journal of Clinical and Experimental Investigations 2/2 (June 2011), 138-143. https://doi.org/10.5799/ahinjs.01.2011.02.0227.
JAMA Karaaslan D, Peker TT, Kırdemir P, Nayır E, Özorak Ö, Kosat H. Kas gevşeticiler olmadan remifentanil ile kombine edilen sevofluran veya propofol ile entübasyonun etkinliği. J Clin Exp Invest. 2011;2:138–143.
MLA Karaaslan, Dilek et al. “Kas gevşeticiler Olmadan Remifentanil Ile Kombine Edilen Sevofluran Veya Propofol Ile entübasyonun etkinliği”. Journal of Clinical and Experimental Investigations, vol. 2, no. 2, 2011, pp. 138-43, doi:10.5799/ahinjs.01.2011.02.0227.
Vancouver Karaaslan D, Peker TT, Kırdemir P, Nayır E, Özorak Ö, Kosat H. Kas gevşeticiler olmadan remifentanil ile kombine edilen sevofluran veya propofol ile entübasyonun etkinliği. J Clin Exp Invest. 2011;2(2):138-43.