Propofol for intubation of infants after halothane induction

The unwanted side effects of muscle relax ants used for anaesthesia in the newborn and infants resulted in a search for alternatives to atraumatic int ubation (IN). The study was aimed to investigate conditions of intubation, time of intubation as well as changes in systolic, mean and diastolic blood pressure (RRs/RRm/RRd) and heart rate (HR) under the use of propofol (P) a fter narcosis induction by mask. Patients and methods: The study was approved by the local ethics committee. The data was analysed from 100 infants aged between 4 days and 56 weeks (w eight 2110-9230 g) in the ASA I and II groups (Group [Gr] A and B both with 50 patients). In both groups induction was performed inhalationally with h alothane (1.5-2.0 vol%) and pure oxygen. After that propofol for intubation was applied in a dose of 2 mg/kg i.v. In Gr A blood pressure and heart rat e were registered at three measuring points (MP):MP 1=before P administrati on, MP 2=after P, MP 3=following intubation; in Gr B at MP 1 and MP 3. Addi tionally in Gr B the intubation rime was recorded in seconds (t1=time after P administration to beginning of IN, t2=time after P administration to the end of the IN, t3=t2-t1). In both groups the conditions of intubation were assessed (score 1 - excellent, 2 - good, 3 - bad,4 impossible intubation). Results: The means of RRs/RRm/RRd/HR varied in Gr A at MP 2 by -11.20*/-9.1 8*/ -8.58*/-3.52 mmHg/bpm and at MP 3 by -2.74/-2.26/-2.04/+5.46 mmHg/bpm i n comparison to MP 1 (p<0.05=significant*). Compared to MP 1 in Gr B the me an values of RRs/RRm/RRd/HR varied at MP 3 by -0.89/+0.50/-0.80/+4.20* mmHg /bpm. T1 (mean,SD) was 10.88+/-3.52 seconds (s), t2 26.22+/-6.12 s, and t3 was therefore 15.78+/-6.28 s. Conditions of intubation were found to be exc ellent or good in both groups (Gr A and B [100 patients]:score 1=95x=95%, s core 2=5x=5%). Conclusion: In the observation period, changes in heart rate stayed in the range of reference. In our opinion the excellent and good conditions for in tubation,as well as the ultrashort drug-onset and intubation rime demonstra te the good characteristics afforded by propofol to perform intubation in i nfancy.