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Induction of anesthesia and endotracheal intubation in children without muscle relaxant : a comparative study on addition of fentanyl or propofol to sevoflurane
Joint Authors
Fawzi, Hazim M.
Samir, Ghadah M.
Source
Ain Shams Journal of Anesthesiology
Issue
Vol. 9, Issue 1 (31 Mar. 2016), pp.39-44, 6 p.
Publisher
Ain Shams University Faculty of Medicine Department of Anesthesiology
Publication Date
2016-03-31
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Intubation without the need of muscle relaxant is a common practice in pediatric patients.
Many drugs are used with inhalational induction to improve the intubation score and to decrease the induction time ; of these drugs are propofol and narcotics.
The aim of this study was to compare the effect of adding propofol or fentanyl to sevofl urane on the intubating conditions in pediatric patients undergoing adenotonsillectomy.
Patients and methods A randomized controlled study was conducted on 90 patients aged 4–8 years and with ASA physical status I and II scheduled for elective adenotonsillectomy.
Patients were divided by opening a sealed envelope into three equal groups, each consisting of 30 patients.
Group S patients received inhalational induction alone using sevofl urane.
Group SF received 3 mcg/ kg fentanyl intravenously followed by inhalational induction using sevofl urane.
Group SP received 3 mg / kg propofol intravenously followed by inhalational induction using sevofl urane.
The intubation conditions, hemodynamic parameters (heart rate and systolic blood pressure), oxygen saturation, operative time, induction time, and recovery time, were all recorded and statistically analyzed.
Results With respect to the intubating condition, no patient in any of the three groups needed rescue muscle relaxant for intubation.
Group SP showed more acceptable and excellent intubating conditions compared with the other two groups (90 and 83.3 %, respectively).
After 6 min, the heart rate was slower, 106.5 (100–110.5) beats/min, and the systolic blood pressure was lower, 110 (110–115) mmHg, in group SF than in the other two groups.
Induction time was faster, 107 (99.8–117) min, in group SP than in the other two groups.
The recovery time was shorter in group S than in group SF and slightly longer in group SP, with median and interquartile range of 265 (249.5–280) s, 337 (320–360) s, and 500 (496.8–510) s, respectively.
Conclusion Endotracheal intubation without neuromuscular blocking agents in pediatric patients undergoing adenotonsillectomy can be achieved with no serious respiratory or hemodynamic adverse events by adding propofol (3 mg / kg) or fentanyl (3 mcg / kg) to sevofl urane.
Propofol is suitable for rapid induction as it offers the shortest induction time with 83.3 % excellent intubating conditions, whereas fentanyl blunts the stress response to intubation with 46.7 % excellent intubating conditions.
American Psychological Association (APA)
Fawzi, Hazim M.& Samir, Ghadah M.. 2016. Induction of anesthesia and endotracheal intubation in children without muscle relaxant : a comparative study on addition of fentanyl or propofol to sevoflurane. Ain Shams Journal of Anesthesiology،Vol. 9, no. 1, pp.39-44.
https://search.emarefa.net/detail/BIM-678980
Modern Language Association (MLA)
Fawzi, Hazim M.& Samir, Ghadah M.. Induction of anesthesia and endotracheal intubation in children without muscle relaxant : a comparative study on addition of fentanyl or propofol to sevoflurane. Ain Shams Journal of Anesthesiology Vol. 9, no. 1 (Jan. / Mar. 2016), pp.39-44.
https://search.emarefa.net/detail/BIM-678980
American Medical Association (AMA)
Fawzi, Hazim M.& Samir, Ghadah M.. Induction of anesthesia and endotracheal intubation in children without muscle relaxant : a comparative study on addition of fentanyl or propofol to sevoflurane. Ain Shams Journal of Anesthesiology. 2016. Vol. 9, no. 1, pp.39-44.
https://search.emarefa.net/detail/BIM-678980
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 44
Record ID
BIM-678980