European Journal of Molecular & Clinical Medicine

Abstract

Background&Method: The study was conducted with an aim to observe Haemodynamic changes
on Intubating the patients using Propofol and Fentanyl without the use of Muscle Relaxants on
50 normotensive patients of either sex between age 20-50 years. ASA grade I/II at Sanjay
Gandhi Medical College, Rewa, M.P.A detailed preanaesthetic assessment was done. Patients
seeming to have factors responsible for difficult intubation, (receding mandible, buck teeth, bull
neck, etc.) or contraindication to use of Propofol or Fentanyl were excluded from the study.
Weight of all patients was noted. Written consent was taken and patients were kept NPO
overnight.
Result:The patient is not totally paralysed, slight vocal cord movement was seen in 43 cases.
Slight diaphragmatic movement like a small hiccup was seen in 20 cases, mild cough was seen in
7 cases, moderate mandibular relaxation was seen in 14 cases. Limb movement was not
obtained in any patient. Therefore movement of vocal cords was the commonest factor which
was seen to lower the score from 8-9 to 6-7 (excellent to good conditions).However, slight
movement of partially abducted vocal cords was enough to allow placement of ETT in first
attempt in 41 cases with acceptable intubating conditions (89%) within 2 minutes of
administration of InjPropofol.
Conclusion: Acceptable intubating conditions were obtained in 92% patients i.e. 46 patients.
One patient had ideal intubating condition (score 9). 15 patients achieved excellent intubating
conditions. In these 15 patients, trachea could be intubated easily with cords showering slight
movement in partial abduction. These patients achieved a score of 8. Good intubating conditions
were obtained in 30 patients with intubating scores between 6-7, slight vocal cord movement of
partially abducted cords with slight diaphragmatic movement on placement of the tube was
observed. We conclude that Inj. Propofol 2.5 mg/kg preceded by Inj. Fentanyl citrate 2 mcg/kg 5
minute earlier provided good intubating conditions without the use of a muscle relaxant.