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lüll Comparison of two induction regimens using or not using muscle relaxant: impact on postoperative upper airway discomfort Combes X; Andriamifidy L; Dufresne E; Suen P; Sauvat S; Scherrer E; Feiss P; Marty J; Duvaldestin PBr J Anaesth 2007[Aug]; 99 (2): 276-81BACKGROUND: Muscle relaxants facilitate tracheal intubation, but they are often not used for short peripheral surgical procedures. The consequences of this practice on the upper airway are still a matter of controversy. We therefore compared the incidence of post-intubation symptoms in a randomized study comparing patients intubated with or without the use of a muscle relaxant. METHODS: A total of 300 adult patients requiring tracheal intubation for scheduled peripheral surgery were randomly assigned in a double-blind study to an anaesthetic protocol that either included or did not include a muscle relaxant (rocuronium). The primary end-point was the rate of post-intubation symptoms 2 and 24 h after extubation. The secondary end-points were the intubation conditions score (Copenhagen Consensus Conference), the rate of difficult intubations (Intubation Difficulty Scale), and the incidence of adverse haemodynamic events. RESULTS: Post-intubation symptoms were more frequent in patients intubated without the use of a muscle relaxant, whether 2 h (57% vs 43% of patients; P < 0.05) or 24 h (38% vs 26% of patients; P < 0.05) after extubation. Intubation conditions were better when the muscle relaxant was used. In patients intubated without a muscle relaxant, difficult intubation was more common (12% vs 1%; P < 0.05), as were arterial hypotension or bradycardia requiring treatment (12% vs 3% of patients; P < 0.05). CONCLUSIONS: The use of a muscle relaxant for tracheal intubation diminishes the incidence of adverse postoperative upper airway symptoms, results in better tracheal intubation conditions, and reduces the rate of adverse haemodynamic events.|*Androstanols[MESH]|*Neuromuscular Nondepolarizing Agents[MESH]|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Blood Pressure[MESH]|Double-Blind Method[MESH]|Female[MESH]|Heart Rate[MESH]|Humans[MESH]|Intubation, Intratracheal/*adverse effects/methods[MESH]|Male[MESH]|Middle Aged[MESH]|Pharyngitis/*etiology[MESH]|Postoperative Complications[MESH]|Prospective Studies[MESH]|Rocuronium[MESH] |