Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
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.
OBJECTIVE :
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.
RESULTS:
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).
CONCLUSION:
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.