Evaluación clínica de la calidad de la intubación endotraqueal con remifentanilo-propofol-sevoflurano comparada con remifentanilo-propofol-rocuronio: ensayo clínico aleatorizado, doble ciego

Obregón, María Patricia González; Díaz, Roberto Carlo Rivera; Molina, J.E. Ordoñez; Díaz, Johan Sebastián Rivera; Ossa, Luis Fernando Velásquez; Ibarra, C. Pineda; Gutiérrez, Jorge; Botero, Vega

doi:10.1016/s0034-9356(10)70247-4

Cited by 6 publications

(2 citation statements)

References 26 publications

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“…We suppose that sevoflurane contributed to this low incidence of vocal cord injuries because the intubating conditions at the vocal cords were clinically acceptable in 98%. Obregon et al showed that adding sevoflurane to propofol and remifentanil gave the same incidence of hoarseness as propofol, remifentanil and rocuronium [34]. We confirmed these results; in addition, we showed that laryngeal injuries were not more common under sevoflurane anaesthesia.…”

Section: Discussionsupporting

confidence: 85%

Intubating conditions and side effects of propofol, remifentanil and sevoflurane compared with propofol, remifentanil and rocuronium: a randomised, prospective, clinical trial

et al. 2014

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BackgroundTracheal intubation without muscle relaxants is usually performed with remifentanil and propofol or sevoflurane. Remifentanil 1.0 to 4.0 μg·kg-1 and propofol 2.0-3.0 mg·kg-1 or sevoflurane up to 8.0 Vol% provide acceptable, i.e. excellent or good intubating conditions. We hypothesized that sevoflurane 1.0 MAC would provide acceptable intubating conditions when combined with propofol and remifentanil.MethodsEighty-three patients to be intubated were randomised to two groups. The SEVO group received propofol 1.5 mg kg-1, remifentanil 0.30 μg kg min-1 and sevoflurane 1.0 MAC; the MR group received the same doses of propofol and remifentanil plus rocuronium 0.45 mg kg-1. We evaluated intubation and extubation conditions, mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS). The vocal cords were examined for injury by videolaryngoscopy before and 24 hours after surgery.ResultsAcceptable intubating conditions were seen more frequently with rocuronium than with sevoflurane: 97% versus 82%; p = 0.03; the subscore for vocal cords was comparable: 100% versus 98%. MAP before intubation decreased significantly compared with the MAP at baseline to the same extent in both groups; ephedrine IV was given in 15 (SEVO) versus 16 (MR) patients; p = 0.93. BIS at tracheal intubation was 27 (13-65) in the SEVO group, 29 (14-62) in the MR group; p = 0.07. Vocal cord injuries (oedema, haematoma) were similar: 4 patients in each group.ConclusionsOverall intubating conditions were better when rocuronium was used; the subscore for vocal cords was comparable. The incidence of side effects was the same in the two groups.Trial registrationClinicalTrials.Gov: NCT 01591031.

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Section: Discussionsupporting

confidence: 85%

Intubating conditions and side effects of propofol, remifentanil and sevoflurane compared with propofol, remifentanil and rocuronium: a randomised, prospective, clinical trial

et al. 2014

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“… 12 In 2010, González Obregón et al. 13 showed that addition of Sevo to propofol and remifentanil resulted in an incidence of hoarseness comparable with that in patients receiving rocuronium. In 2014, we confirmed these results and proved that vocal cord injuries were not increased with a muscle relaxant-free induction technique using propofol, remifentanil, and Sevo.…”

Section: Discussionmentioning

confidence: 99%

Sevoflurane at 1.0 MAC together with remifentanil and propofol produces clinically acceptable intubation conditions at the vocal cords: A prospective randomized study

et al. 2017

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ObjectiveThe overall intubation conditions after tracheal intubation with remifentanil, propofol, and sevoflurane at 1.0 minimum alveolar concentration (MAC) are worse than with rocuronium at 0.45 mg/kg. Therefore, we compared the intubation conditions and laryngeal morbidity (vocal cord injuries, hoarseness, and sore throat) with sevoflurane at 1.2 and 1.4 MAC versus 1.0 MAC.MethodsIn this prospective clinical trial, 90 patients were randomized to 3 groups: the sevoflurane 1.0, 1.2, and 1.4 MAC groups. At 3 min, tracheal intubation was performed and the patients’ intubation conditions were assessed. The vocal cords were examined for injury by videolaryngoscopy. Additionally, the incidence and severity of laryngeal morbidity were compared between women and men.ResultsAcceptable intubation conditions were seen in 72% of the patients without significant differences between the groups. Overall, vocal cord injuries (oedema) occurred in three (4%) patients. Women reported sore throat more often than men (51% vs. 21%, respectively).ConclusionsIntubation conditions were not improved with higher sevoflurane concentrations. The incidence and severity of sore throat were greater in women than men.Trial registration: ClinicalTrials.Gov: NCT 01896245

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Avoidance versus use of neuromuscular blocking agents for improving conditions during tracheal intubation or direct laryngoscopy in adults and adolescents

Lundstrøm

Duez

Nørskov

et al. 2017

Cochrane Database of Systematic Reviews

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Evaluación clínica de la calidad de la intubación endotraqueal con remifentanilo-propofol-sevoflurano comparada con remifentanilo-propofol-rocuronio: ensayo clínico aleatorizado, doble ciego

Cited by 6 publications

References 26 publications

Intubating conditions and side effects of propofol, remifentanil and sevoflurane compared with propofol, remifentanil and rocuronium: a randomised, prospective, clinical trial

Intubating conditions and side effects of propofol, remifentanil and sevoflurane compared with propofol, remifentanil and rocuronium: a randomised, prospective, clinical trial

Sevoflurane at 1.0 MAC together with remifentanil and propofol produces clinically acceptable intubation conditions at the vocal cords: A prospective randomized study

Avoidance versus use of neuromuscular blocking agents for improving conditions during tracheal intubation or direct laryngoscopy in adults and adolescents

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