Evaluation of Endotracheal Intubation with and without Neuromuscular Blocking in Pediatric Anesthesia
Iraqi Postgraduate Medical Journal,
2018, Volume 17, Issue 3, Pages 220-224
Endotracheal intubation is an important step in airway control in pediatric age group, the drugs used for this purpose are ultra-short acting hypnotic agents plus neuromuscular blocking agents (NMBA). NMBA have many serious side effects.
To evaluate endotracheal intubation without using NMBA, and assess the intubation conditions and hemodynamic response to this method of intubation in pediatric age group
PATIENTS AND METHOD:
This is a prospective randomized double blind study done in Rizgary teaching general hospital from 1/ October to 1/ December 2012 included 60 patients age 4-8 years,American society of anesthesiologist (ASA) I or II.
Patients were allotted to one of these two groups randomly 30 patients per each group. Group (F): those patients that receive Fentanyl 4 μg/kg I.V +Propofol 3 mg/kg I.V. Group (S): those patients that receivePropofol 3 mg/kg +suxamethonium 1 mg/kg I.V. Intubation conditions and hemodynamic changes have been measured and compared between both groups.
In group F acceptable intubation conditions were obtained in 27 (89%) patients.whileFair intubation conditions occurred in only 3 (11%) patients. In group S acceptable intubation conditionsoccurred in 30 (100%) of patients.In S group there was a significant rise in systolic arterial pressure(SAP) and heart rate (HR) in 0, 1, 3 minute after intubation (P<0.001).
In F group there was significant decrease in SAP (P<0.001) in post induction reading. In F group there was non-significant decrease in HR in post intubation time 1, 3 minutes (P>0.05).
Endotracheal intubation can be accomplished in pediatric age group using Fentanyl and Propofol without the need to use muscle relaxant with acceptable hemodynamic response.
KEY WORDS: endotracheal intubation, fentanyl, Propofol, suxamethonium.
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