We have investigated the effect of augmentation of propofol with alfentanil for nasotracheal intubation without neuromuscular block in 60 patients undergoing short elective maxillo-facial procedures as outpatients. After administration of glycopyrronium 5 micrograms kg-1 i.v., anaesthesia was induced with propofol 2.5 mg kg-1, or alfentanil 20 micrograms kg-1 and propofol 2.5 mg kg-1. The alfentanil group had improved jaw relaxation (P < 0.001) and vocal cord conditions (P < 0.005). Tracheal intubation was successful in 83% of patients receiving alfentanil, and in 73% of patients receiving propofol only. This difference was not significant. The cardiovascular response to intubation was attenuated in the alfentanil group.

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