Orotracheal intubation without the use of muscle relaxant: Propofol or etomidate in combination with remifentanil

"Introduction: Remifentanil followed by propofol provides adequate conditions for tracheal intubation without using muscle relaxants. Other hypnotic drugs have not been thoroughly evaluated in this regard. The purpose of this study was to assess intubating conditions and cardiovascular changes...

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Autores Principales: Rincón J.A., Hernández A., Charris H., Montes F.R.
Formato: Artículo (Article)
Lenguaje:Español (Spanish)
Publicado: Sociedad Colombiana de Anestesiologia y Reanimacion SCARE 2009
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Acceso en línea:https://repository.urosario.edu.co/handle/10336/22972
id ir-10336-22972
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spelling ir-10336-229722021-01-21T08:24:37Z Orotracheal intubation without the use of muscle relaxant: Propofol or etomidate in combination with remifentanil Intubación orotraqueal sin relajante muscular: Propofol o etomidato en combinación con remifentanilo Rincón J.A. Hernández A. Charris H. Montes F.R. Anesthesia Intratracheal Intubation Muscle relaxation "Introduction: Remifentanil followed by propofol provides adequate conditions for tracheal intubation without using muscle relaxants. Other hypnotic drugs have not been thoroughly evaluated in this regard. The purpose of this study was to assess intubating conditions and cardiovascular changes after induction of anesthesia with remifentanil-propofol or. Methods: 90 ASA I/II patients were enrolled in this random, prospective, double-blind study. Subjects received 0.03 mg/kg of midazolam followed by a 7 ml/kg infusion of Ringe?s lactate. After that, 3 ?g/kg of remifentanil were injected followed by lydocaine, 1 mg/kg. Then, patients received either propofol (2 mg/ kg) (Propofol Group, n= 29), or etomidate (0.3 mg/kg) (Etomidate 3 Group, n=31) or etomidate (0.4 mg/kg) (Etomidate 4 Group, n=30). Subsequent laryngoscope and intubation were performed. Intubating conditions were assessed using a quality scoring system. Mean arterial pressure and heart rates pre-induction, post-induction were recorded immediately after intubation and every 1 to 5 minutes after intubation. Results: Three patients in the etomidate 3 Group and two patients in the etomidate 4 Group were not able to be intubated in the first attempt. Clinically acceptable intubating conditions were observed in 100%, 74%, 80% in the Propofol, Etomidate 3 and etomodate 4 groups, respectively (p=0.01 6). The decrease in mean arterial pressure was significantly higher in the propofol group as compared to the etomidate 3 group (p less than 0.05). Conclusions: The use of lydocaine-remifentanil-propofol for tracheal intubation without muscle relaxants is superior to 0.3 or 0.4 mg/kg lydocaine-remifentanil plus etomidate. However, etomidate 0.3 mg/kg produces a better hemodynamic profile when compared to propofol." 2009 2020-05-25T23:59:02Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 1203347 https://repository.urosario.edu.co/handle/10336/22972 spa info:eu-repo/semantics/openAccess application/pdf Sociedad Colombiana de Anestesiologia y Reanimacion SCARE instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR
institution EdocUR - Universidad del Rosario
collection DSpace
language Español (Spanish)
topic Anesthesia
Intratracheal
Intubation
Muscle relaxation
spellingShingle Anesthesia
Intratracheal
Intubation
Muscle relaxation
Rincón J.A.
Hernández A.
Charris H.
Montes F.R.
Orotracheal intubation without the use of muscle relaxant: Propofol or etomidate in combination with remifentanil
description "Introduction: Remifentanil followed by propofol provides adequate conditions for tracheal intubation without using muscle relaxants. Other hypnotic drugs have not been thoroughly evaluated in this regard. The purpose of this study was to assess intubating conditions and cardiovascular changes after induction of anesthesia with remifentanil-propofol or. Methods: 90 ASA I/II patients were enrolled in this random, prospective, double-blind study. Subjects received 0.03 mg/kg of midazolam followed by a 7 ml/kg infusion of Ringe?s lactate. After that, 3 ?g/kg of remifentanil were injected followed by lydocaine, 1 mg/kg. Then, patients received either propofol (2 mg/ kg) (Propofol Group, n= 29), or etomidate (0.3 mg/kg) (Etomidate 3 Group, n=31) or etomidate (0.4 mg/kg) (Etomidate 4 Group, n=30). Subsequent laryngoscope and intubation were performed. Intubating conditions were assessed using a quality scoring system. Mean arterial pressure and heart rates pre-induction, post-induction were recorded immediately after intubation and every 1 to 5 minutes after intubation. Results: Three patients in the etomidate 3 Group and two patients in the etomidate 4 Group were not able to be intubated in the first attempt. Clinically acceptable intubating conditions were observed in 100%, 74%, 80% in the Propofol, Etomidate 3 and etomodate 4 groups, respectively (p=0.01 6). The decrease in mean arterial pressure was significantly higher in the propofol group as compared to the etomidate 3 group (p less than 0.05). Conclusions: The use of lydocaine-remifentanil-propofol for tracheal intubation without muscle relaxants is superior to 0.3 or 0.4 mg/kg lydocaine-remifentanil plus etomidate. However, etomidate 0.3 mg/kg produces a better hemodynamic profile when compared to propofol."
format Artículo (Article)
author Rincón J.A.
Hernández A.
Charris H.
Montes F.R.
author_facet Rincón J.A.
Hernández A.
Charris H.
Montes F.R.
author_sort Rincón J.A.
title Orotracheal intubation without the use of muscle relaxant: Propofol or etomidate in combination with remifentanil
title_short Orotracheal intubation without the use of muscle relaxant: Propofol or etomidate in combination with remifentanil
title_full Orotracheal intubation without the use of muscle relaxant: Propofol or etomidate in combination with remifentanil
title_fullStr Orotracheal intubation without the use of muscle relaxant: Propofol or etomidate in combination with remifentanil
title_full_unstemmed Orotracheal intubation without the use of muscle relaxant: Propofol or etomidate in combination with remifentanil
title_sort orotracheal intubation without the use of muscle relaxant: propofol or etomidate in combination with remifentanil
publisher Sociedad Colombiana de Anestesiologia y Reanimacion SCARE
publishDate 2009
url https://repository.urosario.edu.co/handle/10336/22972
_version_ 1690577197998276608
score 11,828437