• C Baillard, F Adnet, S W Borron, S X Racine, F Ait Kaci, J L Fournier, P Larmignat, M Cupa, and C M Samama.
• Hôpital Avicenne, APHP, Département d'Anesthésie-Réanimation and SAMU 93-EA 3409, Bobigny Cedex, France. christophe.baillard@avc.ap-hop-paris.fr
• Eur J Anaesthesiol. 2005 Sep 1;22(9):672-7.

Background And ObjectiveThe ease of endotracheal intubation has been recently shown to affect the incidence of laryngeal injury. There remains controversy as to whether or not a muscle relaxant is routinely required for tracheal intubation. This study examined conditions of intubation in our routine practice, which employs a relaxant-sparing approach.MethodsAll adult patients scheduled for surgery with general anaesthesia were prospectively included. A muscle relaxant was used to facilitate intubation when it was required for the surgical procedure and/or otherwise regarded as necessary by the anaesthesiologist. In the remaining patients, a relaxant-free intubation was performed. Intubating conditions were evaluated in all the patients as well as the post-intubation laryngeal symptoms.ResultsBetween March and July 2003, 612 patients were consecutively included. A muscle relaxant was used in 32% of patients and no relaxant in the remaining patients (68%). Clinically acceptable intubating scores were observed in 98.4% overall with no significant difference between the two groups. Excellent conditions occurred more frequently in the relaxant group as compared to the relaxant-free group, 87% vs. 72%, P = 0.005. Laryngeal symptoms occurred in 184 (33%) patients with no difference between the two groups.ConclusionsOur relaxant-sparing approach did not increase the incidence of poor conditions of intubation nor laryngeal symptoms. However, excellent conditions occurred more frequently in the relaxant group. A more flexible approach to the issue of the need for neuromuscular blockade prior to intubation is proposed.

35 keywords...

hide…