Intubating conditions and side effects of propofol, remifentanil and sevoflurane compared with propofol, remifentanil and rocuronium: a randomised, prospective, clinical trial.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968535 Publication Model: eCollection Cited Medium: Print ISSN: 1471-2253 (Print) Linking ISSN: 14712253 NLM ISO Abbreviation: BMC Anesthesiol Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BioMed Central, 2001-
    • Subject Terms:
      Anesthetics, Inhalation/*administration & dosage ; Anesthetics, Intravenous/*administration & dosage ; Intubation, Intratracheal/*methods ; Neuromuscular Nondepolarizing Agents/*administration & dosage; Aged ; Androstanols/administration & dosage ; Androstanols/adverse effects ; Anesthetics, Combined/administration & dosage ; Anesthetics, Combined/adverse effects ; Anesthetics, Inhalation/adverse effects ; Anesthetics, Intravenous/adverse effects ; Arterial Pressure/drug effects ; Consciousness Monitors ; Female ; Heart Rate/drug effects ; Humans ; Male ; Methyl Ethers/administration & dosage ; Methyl Ethers/adverse effects ; Middle Aged ; Neuromuscular Nondepolarizing Agents/adverse effects ; Piperidines/administration & dosage ; Piperidines/adverse effects ; Propofol/administration & dosage ; Propofol/adverse effects ; Prospective Studies ; Remifentanil ; Rocuronium ; Sevoflurane ; Vocal Cords/injuries
    • Abstract:
      Background: Tracheal intubation without muscle relaxants is usually performed with remifentanil and propofol or sevoflurane. Remifentanil 1.0 to 4.0 μg·kg(-1) and propofol 2.0-3.0 mg·kg(-1) or sevoflurane up to 8.0 Vol% provide acceptable, i.e. excellent or good intubating conditions. We hypothesized that sevoflurane 1.0 MAC would provide acceptable intubating conditions when combined with propofol and remifentanil.
      Methods: Eighty-three patients to be intubated were randomised to two groups. The SEVO group received propofol 1.5 mg kg(-1), remifentanil 0.30 μg kg min(-1) and sevoflurane 1.0 MAC; the MR group received the same doses of propofol and remifentanil plus rocuronium 0.45 mg kg(-1). We evaluated intubation and extubation conditions, mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS). The vocal cords were examined for injury by videolaryngoscopy before and 24 hours after surgery.
      Results: ACCEPTABLE INTUBATING CONDITIONS WERE SEEN MORE FREQUENTLY WITH ROCURONIUM THAN WITH SEVOFLURANE: 97% versus 82%; p = 0.03; the subscore for vocal cords was comparable: 100% versus 98%. MAP before intubation decreased significantly compared with the MAP at baseline to the same extent in both groups; ephedrine IV was given in 15 (SEVO) versus 16 (MR) patients; p = 0.93. BIS at tracheal intubation was 27 (13-65) in the SEVO group, 29 (14-62) in the MR group; p = 0.07. Vocal cord injuries (oedema, haematoma) were similar: 4 patients in each group.
      Conclusions: Overall intubating conditions were better when rocuronium was used; the subscore for vocal cords was comparable. The incidence of side effects was the same in the two groups.
      Trial Registration: ClinicalTrials.Gov: NCT 01591031.
    • References:
      Anaesthesia. 1999 May;54(5):444-53. (PMID: 10995141)
      Anesthesiology. 2003 May;98(5):1049-56. (PMID: 12717124)
      Eur J Anaesthesiol. 2005 Sep;22(9):672-7. (PMID: 16163913)
      Anesth Analg. 2001 Feb;92(2):523-8. (PMID: 11159262)
      Anesthesiology. 2013 Dec;119(6):1360-9. (PMID: 24071617)
      Anesth Analg. 2012 May;114(5):980-6. (PMID: 22492188)
      Anaesthesia. 2000 Oct;55(10):965-9. (PMID: 11012491)
      Br J Anaesth. 1978 Jun;50(6):587-90. (PMID: 666934)
      Anesthesiology. 2009 Apr;110(4):891-7. (PMID: 19293691)
      Rev Esp Anestesiol Reanim. 2010 Jun-Jul;57(6):351-6. (PMID: 20645486)
      Curr Opin Anaesthesiol. 2009 Dec;22(6):725-9. (PMID: 19680121)
      Eur J Anaesthesiol. 2003 Jan;20(1):37-43. (PMID: 12557834)
      J Int Med Res. 2013 Oct;41(5):1632-8. (PMID: 24008568)
      Br J Anaesth. 2005 Feb;94(2):150-8. (PMID: 15516354)
      Anesth Analg. 1994 Aug;79(2):378-81. (PMID: 7639383)
      Can J Anaesth. 2008 Oct;55(10):674-84. (PMID: 18835965)
      Drugs. 1996 Apr;51(4):658-700. (PMID: 8706599)
      Anaesthesia. 2011 Mar;66(3):163-7. (PMID: 21265818)
      Acta Anaesthesiol Scand. 2007 Aug;51(7):789-808. (PMID: 17635389)
      Anaesthesia. 2009 Jul;64(7):719-26. (PMID: 19624626)
      Br J Anaesth. 1996 Sep;77(3):339-42. (PMID: 8949806)
      Arch Otolaryngol Head Neck Surg. 2012 Mar;138(3):257-64. (PMID: 22431870)
      Acta Anaesthesiol Scand. 2010 Feb;54(2):127-8. (PMID: 20078448)
      Can J Anaesth. 2003 Feb;50(2):108-15. (PMID: 12560298)
      Br J Anaesth. 2009 Aug;103(2):283-90. (PMID: 19457894)
      Anesth Analg. 1998 Jan;86(1):45-9. (PMID: 9428849)
      Drugs Aging. 2012 Nov;29(11):905-9. (PMID: 23090780)
      Anesth Analg. 2006 Jan;102(1):306-12. (PMID: 16368848)
      Eur J Anaesthesiol. 2003 Aug;20(8):624-30. (PMID: 12932063)
      Ann Otol Rhinol Laryngol. 1983 Jul-Aug;92(4 Pt 1):327-30. (PMID: 6881831)
      Anaesthesist. 2006 Jun;55(6):668-78. (PMID: 16609885)
      Br J Anaesth. 2007 Aug;99(2):276-81. (PMID: 17573390)
      J Voice. 2007 Nov;21(6):762-8. (PMID: 16905292)
    • Contributed Indexing:
      Keywords: Intubating conditions; Laryngeal injury; Neuromuscular block; Propofol; Remifentanil; Sevoflurane
      Note: Original DateCompleted: 20140526
    • Molecular Sequence:
      ClinicalTrials.gov NCT01591031
    • Accession Number:
      0 (Androstanols)
      0 (Anesthetics, Combined)
      0 (Anesthetics, Inhalation)
      0 (Anesthetics, Intravenous)
      0 (Methyl Ethers)
      0 (Neuromuscular Nondepolarizing Agents)
      0 (Piperidines)
      38LVP0K73A (Sevoflurane)
      P10582JYYK (Remifentanil)
      WRE554RFEZ (Rocuronium)
      YI7VU623SF (Propofol)
    • Publication Date:
      Date Created: 20140527 Date Completed: 20151021 Latest Revision: 20220331
    • Publication Date:
      20221213
    • Accession Number:
      PMC4032635
    • Accession Number:
      10.1186/1471-2253-14-39
    • Accession Number:
      24860256