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| Research article summary (published 30 Aug 2003): |
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Awake nasotracheal fiberoptic intubation: patient comfort, intubating conditions, and hemodynamic stability during conscious sedation with remifentanil.
Full Abstract
Awake nasotracheal fiberoptic intubation requires an anesthetic management that provides sufficient patient comfort, adequate intubating conditions, and stable hemodynamics. Short-acting and easily titratable analgesics are excellent choices for this maneuver. In this study, our aim was to determine an appropriate dosage regimen of remifentanil for awake nasotracheal fiberoptic intubation. For that reason, we compared two different dosage regimens. Twenty-four patients were randomly assigned to receive remifentanil 0.75 micro g/kg in bolus, followed by a continuous infusion of 0.075 micro g x kg(-1) x min(-1) (Group L), or remifentanil 1.5 micro g/kg in bolus, followed by a continuous infusion of 0.15 micro g x kg(-1) x min(-1) (Group H). All patients were premedicated with midazolam 0.05 mg/kg IV and glycopyrrolate 0.2 mg IV. Both dosage regimens ensured patient comfort and sedation. Discomfort did not differ between groups. Patients in Group H were sedated more profoundly. Hemodynamic stability was maintained with both remifentanil doses. Intubating conditions were adequate in all patients and comparable between the groups. The large dosage regimen did not result in any additional benefit compared with the small dosage. For awake nasotracheal fiberoptic intubation, we therefore recommend remifentanil 0.75 micro g/kg in bolus followed by continuous infusion of 0.075 micro g x kg(-1) x min(-1), supplemented with midazolam 0.05 mg/kg.
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Author information
Author/s: Machata, Anette-Marie (AM); Gonano, Christopher (C); Holzer, Andrea (A); Andel, Dorothea (D); Spiss, Christian K (CK); Zimpfer, Michael (M); Illievich, Udo M (UM);
Affiliation: Department of Anesthesiology and General Intensive Care, University of Vienna, Austria. anette-marie.machata@univie.ac.at
Journal and publication information
Publication Type: Clinical Trial; Journal Article; Randomized Controlled Trial
Journal: Anesthesia and analgesia (Anesth Analg), published in United States. (Language: eng)
Reference: 2003-Sep; vol 97 (issue 3) : pp 904-8
Dates: Created 2003/08/22; Completed 2003/09/15; Revised 2007/11/15;
PMID: 12933427, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
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