Tracheal intubation in children after induction of anesthesia with propofol and remifentanil without a muscle relaxant

Abstract

Objectives To determine the suitable and ideal doses of remifentanil which provide acceptable tracheal intubating conditions in children given propofol. Methods This prospective double blind trial was performed on 60 ASA 1 and 2 children aged between 3 and 12 years at Nikokari University Hospital, Tabriz, Iran from June 2007 to April 2008. The patients were randomly allocated to one of four groups. Patients in groups 1, 2, 3, and 4 received 1, 2, 3?g/kg remifentanil; and 0.5mg/kg atracurium, respectively. Then, all patients were injected 3 mg/kg of propofol, and underwent tracheal intubation. The intubating conditions were evaluated and recorded according to the HelboHansen scoring system. Results Tracheal intubation was successful in 58 of 60 patients. Intubation failed only in two patients of group 1, but was performed after injection of additional drug. The difference of total conditions of tracheal intubation between groups 1 and 4 was significant (33% vs. 80%); the difference of total conditions between groups 3 and 4 was not significant (P=0.427); but the difference of total conditions between 4 groups was significant (P=0.043). Conclusion Intubating conditions in children following administration of remifentanil 3 ?g/kg were more suitable who were given propofol.