Tracheal intubation in routine practice with and without muscular relaxation
| Autor: | J. L. Fournier, S. X. Racine, C. Baillard, Frédéric Adnet, F. Ait Kaci, Stephen W. Borron, Charles-Marc Samama, Michel Cupa, P. Larmignat |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Larynx medicine.medical_specialty Sufentanil medicine.drug_class Midazolam medicine.medical_treatment Laryngoscopy Pain Intubation Intratracheal medicine Humans Hypnotics and Sedatives Intubation Prospective Studies Prospective cohort study Propofol Voice Disorders medicine.diagnostic_test business.industry Tracheal intubation Muscle relaxant Middle Aged Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Hydroxyzine Anesthesia Atracurium Neuromuscular Blockade Female business Anesthetics Intravenous Preanesthetic Medication Follow-Up Studies Neuromuscular Nondepolarizing Agents medicine.drug |
| Zdroj: | European Journal of Anaesthesiology. 22:672-677 |
| ISSN: | 0265-0215 |
| DOI: | 10.1017/s0265021505001110 |
| Popis: | The ease of endotracheal intubation has been recently shown to affect the incidence of laryngeal injury. There remains controversy as to whether or not a muscle relaxant is routinely required for tracheal intubation. This study examined conditions of intubation in our routine practice, which employs a relaxant-sparing approach.All adult patients scheduled for surgery with general anaesthesia were prospectively included. A muscle relaxant was used to facilitate intubation when it was required for the surgical procedure and/or otherwise regarded as necessary by the anaesthesiologist. In the remaining patients, a relaxant-free intubation was performed. Intubating conditions were evaluated in all the patients as well as the post-intubation laryngeal symptoms.Between March and July 2003, 612 patients were consecutively included. A muscle relaxant was used in 32% of patients and no relaxant in the remaining patients (68%). Clinically acceptable intubating scores were observed in 98.4% overall with no significant difference between the two groups. Excellent conditions occurred more frequently in the relaxant group as compared to the relaxant-free group, 87% vs. 72%, P = 0.005. Laryngeal symptoms occurred in 184 (33%) patients with no difference between the two groups.Our relaxant-sparing approach did not increase the incidence of poor conditions of intubation nor laryngeal symptoms. However, excellent conditions occurred more frequently in the relaxant group. A more flexible approach to the issue of the need for neuromuscular blockade prior to intubation is proposed. |
| Databáze: | OpenAIRE |
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