Intubation without muscle relaxation for suspension laryngoscopy: a randomized, controlled study

Niger J Clin Pract. 2014 Jul-Aug;17(4):456-61. doi: 10.4103/1119-3077.134038.

Abstract

Objective and aim: The objective of the following study is to examine the effectiveness and safety of suspension laryngoscopy under intubation with propofol and remifentanil alone for vocal fold nodule (VFN) excision.

Materials and methods: A total of 40 patients were equally and randomly assigned to elective VFN excision using suspension laryngoscopy under intubation with propofol and remifentanil alone (Group A) or with supplementary cisatracurium (Group B).

Results: Intubation time was significantly longer in Group A than in Group B (300.0 ± 30.0 s vs. 265.2 ± 38.7 s, P = 0.003). The two groups showed similar Cormack-Lehane classifications, intubation conditions and ease of suspension laryngoscopy. Both groups showed favorable cardiopulmonary safety profiles. Post-anesthesia recovery was significantly more rapid in Group A than in Group B, in terms of times to spontaneous breathing return (7.2 ± 1.4 min vs. 10.9 ± 1.6 min, P < 0.001), consciousness return (7.4 ± 1.5 min vs. 12.3 ± 1.8 min, P < 0.001), removal of tracheal intubation (8.1 ± 1.5 min vs. 13.2 ± 1.7 min, P < 0.001) and operating room discharge (12.7 ± 1.4 min vs. 22.1 ± 1.3 min, P < 0.001).

Conclusion: Use of propofol and remifentanil alone provides favorable intubation and anesthesia conditions for suspension laryngoscopic VFN excision and accelerates post-anesthesia recovery.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anesthetics, Intravenous / therapeutic use*
  • Blood Pressure / drug effects
  • Female
  • Heart Rate / drug effects
  • Humans
  • Intubation, Intratracheal / methods*
  • Laryngoscopy / methods*
  • Male
  • Middle Aged
  • Muscle Relaxants, Central / therapeutic use*
  • Piperidines / therapeutic use
  • Propofol / therapeutic use
  • Remifentanil
  • Time Factors
  • Vocal Cords / surgery

Substances

  • Anesthetics, Intravenous
  • Muscle Relaxants, Central
  • Piperidines
  • Remifentanil
  • Propofol