This study designed to evaluate the use remifentanil followed by propqfol or thiqpental without muscle relaxants for endotracheal intubation compared to thiopentcd followed by succinylcholine as a control group for obtaining clinically acceptable intubation conditions and hemodynamic changes. We studied 90 healthy children (ASA I-Il), aged three to nine years presenting for elective ENT-surgery. The children were enrolled into three equal groups: Group A received remifentanil 3pg/kg followed by 2.5 mg/kg propofoh Group B received remifentanil 3pg/kg followed by 5 mg/ kg thiopental and Group Cos a control group received 5mg thiopentcdfollowed by succinylcholine 1.5 mg/kg. The tracheal intubating conditions were considered excellent in 30 (100%) of children in Group C, 27 (90%) in Groups A and 24 (80%) in Group B. Mask ventilation done easily in all children and complete jaw relaxation in 93.3% of children in Group A, 86.6% in Group B and 100% in Group C (significant difference between Group B and C P<0.05). All children intubated easily, and slight cord movement in 10% of children in Group A and in 20% in Group B (signifi cant difference between Group A and C P<0.05 and a highly significant difference between Group B and C P<0.001). 6.66% of children in Group A and 20% in Group B developed slight coughing at intubation (a highly significant difference between Group B and C P<0.001). As regard the MAP changes after induction and intubation in Group C there was signifi cant difference (P < 0.05) between Group C and B and a very highly sig nificant difference (P < 0.0001) between group A and C. The heart rate de creased 14 %and 2% in the remifentanil groups A and B respectively (P < 0.05) and remained lower than baseline throughout the study |
