Evaluating the Facility of Endotracheal Intubation with Propofol and Alfentanyl without Muscle Relaxants in Elderly Patients

Background: Orotracheal intubation is a common method in critical situations and for performing different surgeries in operating rooms under general anesthesia. The most common depolarizing muscle relaxant for Endotracheal intubation suxamethonium chloride. As this drug and other muscle relaxants have some adverse effects, this study is performed to present an alternative method for Endotracheal intubation without muscle relaxants in some certain situations. Methods: This is a descriptive double blinded study performed on one hundred and fifty elderly patients in ASA class I and II (classification of American Society of Anesthesiologists) which were divided into two groups. Research took place in Nikookari hospital. All patients were elective and general anesthesia technique was performed by Endotracheal intubation. One anesthesiologist was supposed to administer IV anesthetic drugs and another one intubated the patients and evaluated them. Data collection including time of loss of consciousness, jaw relaxation, vocal cords position, patients' response to laryngoscopy, duration and technique of laryngoscopy, and post extubation complications was done using a questionnaire. Statistical analysis included descriptive methods and was performed using SPSS software. Results: In this study 51.7% of the patients were male and 48.3% were female. Average age of the patients were reported 61.19+12.06 and their mean weight was 59+1.06 KG. None of the patients had history of difficult intubation. All the patients were able to do head extension and mouth opening test. In this study a significant difference was observed between the two groups as the following: time of being anesthetized (P<0.001), duration of laryngoscopy (P<0.052), laryngoscopy technique (P<0.05) and response to Orotracheal intubation (P<0.001). Between remained parameters to significant difference was observed. Hemodynamic changes and reduction of its parameters (Blood Pressure, Pulse Rate) were significant in the two groups. SPO2 changes were also evident. Conclusion: Considering adverse effects of muscle relaxants used for intubation and the need of being skillful for performing Endotracheal intubation with some other alternative methods, researchers of this study recommend usage of this technique for patients with mentioned characteristics, according to the obtained results.