Document Detail

Comparison of two induction regimens using or not using muscle relaxant: impact on postoperative upper airway discomfort.
MedLine Citation:
PMID:  17573390     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Muscle relaxants facilitate tracheal intubation, but they are often not used for short peripheral surgical procedures. The consequences of this practice on the upper airway are still a matter of controversy. We therefore compared the incidence of post-intubation symptoms in a randomized study comparing patients intubated with or without the use of a muscle relaxant. METHODS: A total of 300 adult patients requiring tracheal intubation for scheduled peripheral surgery were randomly assigned in a double-blind study to an anaesthetic protocol that either included or did not include a muscle relaxant (rocuronium). The primary end-point was the rate of post-intubation symptoms 2 and 24 h after extubation. The secondary end-points were the intubation conditions score (Copenhagen Consensus Conference), the rate of difficult intubations (Intubation Difficulty Scale), and the incidence of adverse haemodynamic events. RESULTS: Post-intubation symptoms were more frequent in patients intubated without the use of a muscle relaxant, whether 2 h (57% vs 43% of patients; P < 0.05) or 24 h (38% vs 26% of patients; P < 0.05) after extubation. Intubation conditions were better when the muscle relaxant was used. In patients intubated without a muscle relaxant, difficult intubation was more common (12% vs 1%; P < 0.05), as were arterial hypotension or bradycardia requiring treatment (12% vs 3% of patients; P < 0.05). CONCLUSIONS: The use of a muscle relaxant for tracheal intubation diminishes the incidence of adverse postoperative upper airway symptoms, results in better tracheal intubation conditions, and reduces the rate of adverse haemodynamic events.
X Combes; L Andriamifidy; E Dufresne; P Suen; S Sauvat; E Scherrer; P Feiss; J Marty; P Duvaldestin
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-06-15
Journal Detail:
Title:  British journal of anaesthesia     Volume:  99     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-09     Completed Date:  2007-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  276-81     Citation Subset:  IM    
Department of Anesthesia, Henri Mondor Hospital (APHP), 51 avenue du Maréchal de Lattre-de-Tassigny, 94100 Créteil cedex, France.
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MeSH Terms
Blood Pressure
Double-Blind Method
Heart Rate
Intubation, Intratracheal / adverse effects*,  methods
Middle Aged
Neuromuscular Nondepolarizing Agents*
Pharyngitis / etiology*
Postoperative Complications
Prospective Studies
Reg. No./Substance:
0/Androstanols; 0/Neuromuscular Nondepolarizing Agents; 143558-00-3/rocuronium

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