The effect of different doses of propofol on tracheal intubating conditions without muscle relaxant in children

Background and objective Situations may occur in anaesthetic practice where the use of neuromuscular blocking drugs is unsuitable or contraindicated. We investigated the use of propofol given 5 min after fentanyl to perm it e ndotracheal intubation in children. Methods We studied the intubating conditions and cardiovascular parameters in 60 ASA I and II children. intravenous midazolam (0.1 mg kg(-1)) was give n as premedication 5 min before the induction of anaesthesia. The children received different doses of propofol (group I, 2.5 mg kg(-1); group II, 3.0 mg kg(-1); group III, 3.5 mg kg(-1)) preceded by fentanyl (3.0 mug kg(-1)) given 5 min earlier. No neuromuscular blocking agents were administered. T he intubating conditio ns were assessed using a four-point scoring system b ased on the degree of difficulty of laryngoscopy, the position of vocal cor ds and the intensity of coughing. Results Tracheal intubating conditions were adequate in 20% of the patients in group I, in 75% of the patients in group II and in 80% of the patients in group III (P<0.05 for group I vs. groups II and III). Haemodynamic chang es were not significantly different between the groups. Conclusions Propofol (3.0 mg kg(-1)) preceded by fentanyl (3.0 <mu>g kg(-1) ) was adequate for the induction of anaesthesia in children and provided ad equate tracheal intubating conditions without significant haemodynamic chan ges. This method represents a useful alternative technique for tracheal int ubation when neuromuscular blocking drugs are contraindicated or should be avoided.