Evaluation of Endotracheal Intubation with and without Neuromuscular Blocking in Pediatric Anesthesia

, Aras As.Sediq; , Reem Abbas Naem; , Iyad Abbas Salman

	Evaluation of Endotracheal Intubation with and without Neuromuscular Blocking in Pediatric Anesthesia
Iraqi Postgraduate Medical Journal
Article 1, Volume 17, Issue 3, 2018, Pages 220-224 PDF (0 K)
Authors
Aras As.Sediq; Reem Abbas Naem; Iyad Abbas Salman
Abstract
ABSTRACT: BACKGROUND: Endotracheal intubation is an important step in airway control in pediatric age group, the drugs used for this purpose are ultra-short acting hypnotic agents plus neuromuscular blocking agents (NMBA). NMBA have many serious side effects. OBJECTIVE : To evaluate endotracheal intubation without using NMBA, and assess the intubation conditions and hemodynamic response to this method of intubation in pediatric age group PATIENTS AND METHOD: This is a prospective randomized double blind study done in Rizgary teaching general hospital from 1/ October to 1/ December 2012 included 60 patients age 4-8 years,American society of anesthesiologist (ASA) I or II. Patients were allotted to one of these two groups randomly 30 patients per each group. Group (F): those patients that receive Fentanyl 4 μg/kg I.V +Propofol 3 mg/kg I.V. Group (S): those patients that receivePropofol 3 mg/kg +suxamethonium 1 mg/kg I.V. Intubation conditions and hemodynamic changes have been measured and compared between both groups. RESULTS: In group F acceptable intubation conditions were obtained in 27 (89%) patients.whileFair intubation conditions occurred in only 3 (11%) patients. In group S acceptable intubation conditionsoccurred in 30 (100%) of patients.In S group there was a significant rise in systolic arterial pressure(SAP) and heart rate (HR) in 0, 1, 3 minute after intubation (P<0.001). In F group there was significant decrease in SAP (P<0.001) in post induction reading. In F group there was non-significant decrease in HR in post intubation time 1, 3 minutes (P>0.05). CONCLUSION: Endotracheal intubation can be accomplished in pediatric age group using Fentanyl and Propofol without the need to use muscle relaxant with acceptable hemodynamic response. KEY WORDS: endotracheal intubation, fentanyl, Propofol, suxamethonium.

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