Medicinski Glasnik (Feb 2009)
Haemodynamic changes and intubating conditions during tracheal intubation in children under anaesthesia: a comparative study of two induction regiments
Abstract
Aim To compare the haemodynamic changes and intubation conditionsfollowing induction of anaesthesia with alfentanil-propofol-rocuronium with those following alfentanil-propofol combinationin children.Methods A prospective, non-randomized and non blinded trialwas performed in 208 children ( ASA I-II, both gender, aged 2-12years) undergoing elective adenoidectomy with or without tonsillectomy.Children scheduled for tonsillectomy or adenotonsillectomyreceived alfentanil 0.02 mg kg-1, propofol 2 mg kg-1 androcuronium 0.45 mg kg-1 before tracheal intubation (R-group).Children scheduled for adenoidectomy received alfentanil 0.02mg kg-1and propofol 3 mg kg-1 before intubation (C-group). Haemodynamicvalues (heart rate, systolic arterial pressure, diastolicarterial pressure, mean arterial pressure) were recorded at predeterminedtime intervals before surgical incision. The intubatingconditions were evaluated applying the Copenhagen Scoring System(excellent, good, poor).Results There was no statistical difference in haemodynamicbaseline values, neither prior nor after the intubation betweenthe two groups. There was a statistically significant increase inheart rate, systolic and diastolic arterial pressure after intubationin both groups (p<0.05). Mean arterial pressure after the intubationincreased statistically significantly only in R-group (p=0.001).There was no hypotension, bradycardia, hypoxemia or other complications.Overall intubation conditions were scored excellent in72.3%, good in 21.5% and poor in 6.2% patients. There were nosignificant differences in intubation conditions between the twogroups (p=0.244)Conclusion Both induction regiments provided the clinically acceptablehaemodynamics and intubation conditions during trachealintubation in children.
