Online ISSN: 2515-8260

To Observe Haemodynamic Changes On Intubating The Patients Using Propofol And Fentanyl Without The Use Of Muscle Relaxants.

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To Observe Haemodynamic Changes On Intubating The Patients Using Propofol And Fentanyl Without The Use Of Muscle Relaxants.

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.

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