Comparison of propofol-remifentanil with thiopental-remifentanil for tracheal intubation without using muscle relaxants, a double blind randomized and clinical trial study

Abstract

In this study, we compared propofol + remifentanil with thiopental + remifentanil without using muscle relaxant for hemodynamic responses and intubation conditions in 100 ASA1 Class I and II patients were randomly assigned to two equal groups. After premedication with midazolam 0.03 mg kg-1 intravenously, remifentanil 4 μg kg-1 were given in each group. In Group I, propofol 2.5 mg kg-1 and in Group II, thiopental 5 mg kg-1 were given intravenously. After 90s, trachea was intubated. Intubation conditions were classified by the anesthesiologist performing the intubation as: excellent, good, fair and poor. Systolic, mean, diastolic arterial blood pressure and heart rate were recorded as baseline, after the induction and 1, 3, 5, 10, 15 min after the intubation. Data were analyzed by Chi-square, independent t-test, paired t-test and repeated measures ANOVA. p<0.05 was statistically significant. The tracheal intubation conditions were excellent in 60%, good in 32% and fair in 16% of Group I and 42, 42 and 16% in Group II, respectively (p = 0.166). The difference in hemodynamic changes in each group and between the two groups were statistically significant (p = 0.001). In Group I, 52% and in Group II, 24% need intravenous ephedrine for treatment of hypotension (p = 0.004). Atropine were given intravenously in 4 patients of Group I and non of Group II for bradycardia (p = 0.059). The results suggest that propofol 2.5 mg kg-1 + remifentanil 4 μg kg-1 compared with thiopental 5 mg kg-1+ remifentanil 4 μg kg-1 has no priority for tracheal intubation condition but with more hemodynamic changes. © 2006 Asian Network for Scientific Information.