Feasibility of endoscope guided orotracheal intubation without muscle relaxant

Objective To evaluate the feasibility of endoscope-guided orotracheal intubation without muscle relaxant after induction of anesthesia with remifentanil and propofol. Methods Forty patients with ASA class Ⅰ or Ⅱ scheduled for elective operation under general anesthesia were randomly divided into 2 groups (n=20): subjective to endotracheal intubation without muscle relaxant(group N) or endotracheal intubation with rocuronium, a muscle relaxant (group R). Anesthesia in both groups was induced with midazolam, remifentanil, and propofol, and maintained with propofol(3 mg·kg-1·h-1) and remifentanil(0.3 μg·kg-1·min-1) after induction. When patients became unconscious with BIS<60, endotracheal intubation was performed after 2 min mechanical hyperventilation. The number of cases of successful intubation, number of attempts, duration of each attempt, total intubation time, and incidence of adverse reactions during the procedure were recorded. Results There was no difference between the two groups in the number of cases of successful intubation, number of attempts, total intubation time, adverse reactions during the procedure and the incidence of postoperative complications(P>0.05). The comprehensive satisfaction rate for the endotracheal intubation was not different in the two groups with 85% in group N and 95% in group R(P>0.05). Conclusions Endoscope-guided orotracheal intubation is safe and effective in patients without a muscle relaxant. Key words: Muscle relaxant; Endotracheal intubation; Endoscope