• J. Int. Med. Res. · Oct 2013

    Randomized Controlled Trial

    Tracheal intubation in intellectually disabled patients: clinical usefulness of remifentanil and sevoflurane without a muscle relaxant.

    • Esra Cagiran, Can Eyigor, Taner Balcioglu, and Meltem Uyar.
    • Department of Anaesthesia and Reanimation, Faculty of Medicine, Ege University, Izmir, Turkey.
    • J. Int. Med. Res. 2013 Oct 1;41(5):1632-8.

    ObjectiveTo compare two remifentanil doses (1 µg/kg and 2 µg/kg) in order to determine the preferred dose in intellectually disabled patients undergoing day care dental surgery under sevoflurane-induced general anaesthesia.MethodsPatients were randomly assigned to receive either 1 µg/kg (group 1) or 2 µg/kg (group 2) remifentanil; both groups received 8% sevoflurane anaesthesia induction. All other conditions were identical in both groups. Heart rate (HR), mean arterial pressure (MAP) and intubation conditions were assessed.ResultsA total of 27/30 (90.0%) patients in group 1 and 29/30 patients (96.7%) in group 2 had acceptable intubation conditions. Remifentanil administration resulted in significant reductions in HR compared with baseline levels, in both groups. There were no significant between-group differences in HR at any timepoint. MAP decreased significantly compared with baseline in group 2 only.ConclusionSuccessful tracheal intubation in intellectually disabled patients can be accomplished with a combination of 1 µg/kg or 2 µg/kg remifentanil and 8% sevoflurane anaesthesia induction, without the requirement for neuromuscular blocking drugs.

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