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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 4, July-August 2019, Pages 1077-1082
 

Original Article

A Comparative Study of Intubating Condition and Hemodynamic Responses Using Propofol or Thiopentone without Muscle Relaxants

A. Abirami1, R. Jeyakkumar2

1,2Assistant Professor, Department of Anaesthesiology, Tirunelveli Medical College and Hospital, Tamilnadu 627011, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.3

Abstract

Introduction: Muscle relaxants are frequently used to facilitate endotracheal intubation during the induction of anesthesia. However, the administration of short-acting depolarizing muscle relaxants is associated with postoperative myalgias, malignant hyperthermia, hyperkalemia and increased intracranial or intraocular pressure. Aim: To compare the intubating condition and haemodynamic response to induction, laryngoscopy and intubation in patients induced with lignocaine, fentanyl and propofol or lignocaine, fentanyl and thiopentone and intubated without muscle relaxants. Methods: 40 patients were randomly allotted in P group [Propofol group] and T group [Thiopentone group]. Patients with the predicted difficulty of intubation, history of hypertension, history of asthma, drug or alcohol abuse, significant cerebrovascular disease and cardiovascular disease, BMI more than 30 kgm-2 were excluded from the study. The results were compared between both the groups. Jaw relaxation, vocal cord position, patient’s response to laryngoscopy and intubation were assessed and graded as excellent, good, and poor. Results: In this study higher incidence of ideal and acceptable intubating conditions were observed in 95% of patients in P group when compared with T group in which the acceptable intubating conditions were observed in 30% of the patients which is statistically significant (p < 0.05). The mean heart rate was decreased in both the groups after induction, but immediately after intubation, mean heart rate was high in group T, when compared with group P. Conclusion: We conclude that induction with Propofol, Fentanyl and Lignocaine provides better intubating conditions with less haemodynamic response to laryngoscopy and intubation than induction with Thiopentone, Fentanyl and Lignocaine.


Keywords : Propofol; Thiopentone; Intubation without muscle relaxants.
Corresponding Author : R. Jeyakkumar