INTUBATING CONDITIONS AND NEUROMUSCULAR EFFECTS OF MIVACURIUM DURING PROPOFOL-ALFENTANIL ANESTHESIA

In three groups of 20 patients, anaesthetized with propofol and alfent anil, tracheal intubation conditions and the onset of neuromuscular bl ockade after administration of three different doses of mivacurium chl oride (0.11, 0.15, and 0.19 mg/kg = 1.5 X ED(95), 2 X ED(95), and 2.5 X ED(95)) were assessed. Intubation conditions were found to be clinic ally acceptable (good or excellent) in 83% of patients. Eighty-two per cent of patients were successfully intubated on the first attempt aft er 60-90 s. No difference in intubation scores or number of intubation attempts among the three dosage groups were found. We conclude that m ivacurium chloride allows smooth intubation in most patients within 60 -90 s, even with the lowest dose (0.11 mg/kg), after a propofol-alfent anil induction of anaesthesia. However, because there were a few patie nts in whom intubating conditions were inadequate at 60-90 s, we are r eluctant to advocate the preference of mivacurium chloride over suxame thonium for rapid sequence induction in emergency situations.