Format

Send to

Choose Destination
Med Pregl. 2009 Sep-Oct;62(9-10):412-6.

[Endotracheal intubation without the use of muscle relaxants in patients with myasthenia gravis].

[Article in Serbian]

Author information

1
Klinicki centar Srbije, Beograd, Institut za anesteziju i reanimaciju. gvlaikov@eunet.yu

Abstract

INTRODUCTION:

Although muscle relaxants have been widely used to facilitate endotracheal intubation, the administration of these drugs in myasthenic patients may be associated with adverse events.

MATERIAL AND METHODS:

After obtaining Institutional Reviewing Board approval and informed, patient consent, 30 patients with myasthenia gravis were enrolled in a prospective, double-blind, randomized clinical trial. We compared intubating conditions (ease of laryngoscopy, vocal cords, cough, jaw relaxation, limb movement) following fentanyl 2 mg/kg and propofol 2 mg/kg (group PRO, n = 15) vs fentanyl 2 mg/kg and sevoflurane 5% in a 1:2 mixture of oxygen and nitrous oxide (group SEVO, n = 15). The statistical analysis was performed using Student's t test and Chi-quadrate test, p < 0.05 being regarded as significant.

RESULTS:

The overall intubating conditions were excellent in 67% of patients in the group PRO vs 80% of patients in the group SEVO (p > 0.05). One patient in each group had clinically unacceptable conditions for intubation. The mean intubation score was 5.7 +/- 1.0 in the group PRO vs 5.9 +/- 0.9 in the group SEVO (p > 0.05). Three patients receiving propofol and one patient receiving sevoflurane had mild hoarseness after the surgery (p > 0.05).

CONCLUSION:

Both propofol and sevoflurane, supplemented with fentanyl, provide good intubating conditions without the use of muscle relaxants in patients with myasthenia gravis.

PMID:
20391735
[Indexed for MEDLINE]

Supplemental Content

Loading ...
Support Center