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  • 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 P
  • Br J Anaesth 2007[Aug]; 99 (2): 276-81
  • BACKGROUND: 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]





  • *{{pmid17573390}}
    *<b>[http://www.kidney.de/mlpefetch.php?search=17573390 Comparison of two induction regimens using or not using muscle relaxant: impact on postoperative upper airway discomfort ]</b> Br J Anaesth 2007; 99(2) ; 276-81 Combes X; Andriamifidy L; Dufresne E; Suen P; Sauvat S; Scherrer E; Feiss P; Marty J; Duvaldestin P

        *17573390*

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    Br J Anaesth

    276 2.99 2007