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Tracheal intubation after induction of anesthesia in children with propofol--remifentanil or propofol-rocuronium.
Can J Anaesth. 2000 Sep; 47(9):854-9.CJ

Abstract

PURPOSE

To compare the intubating conditions after remifentanil-propofol with those after propofol-rocuronium combination with the aim of determining the optimal dose of remifentanil.

METHODS

In a randomized, double-blind study 80 healthy children aged three to nine years were assigned to one of four groups (n=20): 2 or 4 microgxkg(-1) remifentanil (Re2 or Re4); 2 microgxkg(-1) remifentanil and 0.2 mgxkg(-1) rocuronium (Re2-Ro0.2); 0.4 mgxkg(-1) rocuronium (Ro0.4). After atropine, remifentanil was injected over 30 sec followed by 3.5 mgxkg(-1) propofol and rocuronium. After 60 sec, laryngoscopy and intubation were attempted. Intubating conditions were assessed as excellent, good or poor based on ease of ventilation, jaw relaxation, position of the vocal cords, and coughing to intubation.

RESULTS

In all children intubation was successful. Overall intubating conditions were better (P < 0.01), and the frequency of excellent conditions, 85%, was higher (P < 0.01) in the Re4 group than in the Ro0.4 group. No child manifested signs of muscular rigidity. In the remifentanil groups, arterial pressure decreased 11-13% and heart rate 6-9% after anesthetic induction, and remained at that level throughout the study.

CONCLUSION

The best intubating conditions were produced by the combination of 4 microgxkg(-1) remifentanil and 3.5 mgxkg(-1) propofol. It provided excellent or good intubating conditions in all children without causing undue cardiovascular depression.

Authors+Show Affiliations

Department of Anaesthesia, Otolaryngological Clinic, Helsinki University Central Hospital, Finland. ulla-maija.klemola@huch.fiNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

10989854

Citation

Klemola, U M., and A Hiller. "Tracheal Intubation After Induction of Anesthesia in Children With Propofol--remifentanil or Propofol-rocuronium." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 47, no. 9, 2000, pp. 854-9.
Klemola UM, Hiller A. Tracheal intubation after induction of anesthesia in children with propofol--remifentanil or propofol-rocuronium. Can J Anaesth. 2000;47(9):854-9.
Klemola, U. M., & Hiller, A. (2000). Tracheal intubation after induction of anesthesia in children with propofol--remifentanil or propofol-rocuronium. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 47(9), 854-9.
Klemola UM, Hiller A. Tracheal Intubation After Induction of Anesthesia in Children With Propofol--remifentanil or Propofol-rocuronium. Can J Anaesth. 2000;47(9):854-9. PubMed PMID: 10989854.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tracheal intubation after induction of anesthesia in children with propofol--remifentanil or propofol-rocuronium. AU - Klemola,U M, AU - Hiller,A, PY - 2000/9/16/pubmed PY - 2001/2/28/medline PY - 2000/9/16/entrez SP - 854 EP - 9 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 47 IS - 9 N2 - PURPOSE: To compare the intubating conditions after remifentanil-propofol with those after propofol-rocuronium combination with the aim of determining the optimal dose of remifentanil. METHODS: In a randomized, double-blind study 80 healthy children aged three to nine years were assigned to one of four groups (n=20): 2 or 4 microgxkg(-1) remifentanil (Re2 or Re4); 2 microgxkg(-1) remifentanil and 0.2 mgxkg(-1) rocuronium (Re2-Ro0.2); 0.4 mgxkg(-1) rocuronium (Ro0.4). After atropine, remifentanil was injected over 30 sec followed by 3.5 mgxkg(-1) propofol and rocuronium. After 60 sec, laryngoscopy and intubation were attempted. Intubating conditions were assessed as excellent, good or poor based on ease of ventilation, jaw relaxation, position of the vocal cords, and coughing to intubation. RESULTS: In all children intubation was successful. Overall intubating conditions were better (P < 0.01), and the frequency of excellent conditions, 85%, was higher (P < 0.01) in the Re4 group than in the Ro0.4 group. No child manifested signs of muscular rigidity. In the remifentanil groups, arterial pressure decreased 11-13% and heart rate 6-9% after anesthetic induction, and remained at that level throughout the study. CONCLUSION: The best intubating conditions were produced by the combination of 4 microgxkg(-1) remifentanil and 3.5 mgxkg(-1) propofol. It provided excellent or good intubating conditions in all children without causing undue cardiovascular depression. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/10989854/Tracheal_intubation_after_induction_of_anesthesia_in_children_with_propofol__remifentanil_or_propofol_rocuronium_ L2 - https://doi.org/10.1007/BF03019664 DB - PRIME DP - Unbound Medicine ER -