Tracheal Intubation Without the Use of Neuromuscular Blocking Agents

Dear Editor, I read with keen interest the article by Imani et al. (1) in which the authors compare tracheal intubating conditions following intravenous (IV) administration of remifentanil 5 μg/kg or alfentanil 50 μg/kg followed by induction of anesthesia with propofol 2 mg/kg in 100 adult patients premedicated with IV midazolam 1 mg. Intubating conditions were assessed (scoring 1 to 4) by ease of laryngoscopy, patency of vocal cords, jaw relaxation, and limb movement.