Journal of Anesthesiology and Pain

Background and aims: To compare intubating conditions and cardiovascular changes follow
induction of anesthesia and tracheal intubation in patients receiving either lidocaine-remifentanilpropofol
or lidocaine-remifentanil-sevoflurane prior to induction.
Methods and materials: In a randomized, double-blind study 75 healthy children patients
were assigned to one of two groups: lidocaine 1.5 mg·kg-1, remifentanil 2 μg·kg-1 and propofol
2 mg·kg-1 (Group P) or lidocaine 1.5 mg·kg-1, remifentanil 2 μg·kg-1 and sevoflurane (Group
S). Then laryngoscopy and tracheal intubation were attempted at BIS 40-50. Intubating conditions
were assessed as excellent, good or poor on the basis of ease of ventilation, position of the vocal
cords, and patient's response to intubation and slow inflation of the tracheal cuff. The mean
arterial pressure (MAP) and heart rate (HR) were measured before anesthetic agent
administration, immediately after tracheal intubation, and five minutes after intubation.
Results: Excellent intubating conditions were obtained in 76% of Group P patients and 84% of
Group S patients and were not significantly different between the two groups (p<0.356).
Cardiovascular changes following induction of anesthesia and tracheal intubation were not
significantly different between the two groups.
Conclusion: Lidocaine-remifentanil-sevoflurane is similar and safe like lidocaine-remifentanilpropofol
for tracheal intubation without muscle relaxants in children.