Remifentanil or Alfentanil for Endotracheal Intubation

Dear Editor, In their study Imani et al. (1) have compared the use of remifentanil (5 μg/kg) or alfentanil (50 μg /kg) as adjunct to propofol infusion (2 mg/kg) for rapid sequence anesthesia induction and tracheal intubation without the use of neuromuscular blocking agents in 100 American Socienty of Anesthesiologyists (ASA) I patients aged 20- 50 years. In order to evaluate the effects on intubating conditions the ease of laryngoscopy, patency of vocal cords, jaw relaxation and limb movements were recorded at 1.5 minute after the start of anesthesia induction (10 seconds for opioid infusion + 45 seconds for distribution + 5 seconds for propofol injection + 30 seconds for distribution). According their results both remifentanil and alfentanil provided good intubating conditions, the use of remifentanil was associated to higher rate of vocal cords patency.