Tracheal intubating conditions after induction with propofol, remifentaniland lignocaine

We have studied the intubating conditions in 60 ASA I or II patients, after induction of anaesthesia with propofol 2 mg kg(-1), allocated to one of th e following three groups: group 1, remifentanil 1 mu g kg(-1); group 2, rem ifentanil 1 mu g kg(-1) and lignocaine 1 mu g kg(-1); group 3, remifentanil 2 mu g kg(-1). No neuromuscular blocking agents were administered. Intubat ing conditions were assessed using a four-point scoring system based on eas e of laryngoscopy, jaw relaxation, position of vocal cards, degree of cough ing and limb movement. Overall intubating conditions were acceptable in 35% of patients in group 1, 100% of patients in group 2 and 85% of patients in group 3. There was a statistically significant drop in blood pressure afte r induction in groups 2 and 3, and two patients in each group required ephe drine 6 mg i.v. boluses, as dictated by the intervention criteria (mean art erial pressure fall >25% from baseline). Similarly, there was a drop in hea rt rate in groups 2 and 3, but this did not reach statistical or clinical s ignificance, and no patient required atropine.