Comparison of intubating conditions following thiopental and succbvylcholine versus sevoflurane and Nitrous oxide anesthesia in adults

ABSTRACT

Fifty premedicated patients of physical status 1 or 11 aged 20-50 years, weighing 50-80 kg undergoing elective surgery requiring tracheal intubation were randomized into 2 equal groups of [25 patients each] to receive either succinylcholine or sevoflurane for tracheal intubation. For the succinylcholine group, patients were induced with thiopental 5-7 mg / kg and tracheally intubated after administration of succinylcholine 1 mg I kg i.v. Patients receiving sevoflurane inhalation starting at 1% and incrementally increased every 2-3 breaths up to 7-8% concentration with N20-02 mixture. At the loss of eyelash reflex, ventilation was assisted to establish end tidal CO2 between 30-40 mm Hg and intubation was performed when end - tidal sevoflurane was 8%. We noticed times of various end points of induction [time of loss of eyelash reflex, time to intubation and time to feturn of spontaneous respiration] and adverse airway events. Criteria of jaw relaxation, vocal cords position and intubating response were used to assess intubation conditions. If the intubation score was intubation condition. Mean time from induction to loss of eyelash reflex and time of intubation were longer in sevoflurane group than succinylcholine group [P<0.01]. Spontaneous respiration was longer in succinylcholine group than sevoflurane group [p<0.05]. No adverse events occurred between groups during induction. Tracheal intubation was nearly successful in all patients of both groups from first attempt without intervention, while 4 patients in sevoflurane group had tracheal intubation after a second attempt. The intubating conditions were either excellent in [80%] or good in [20%] in all patients after thiopental and saccinylcholine, following sevojlurane, the intubating conditions were excellent in [36%] and good in 52% of patients. Clinically acceptable intubating condition were observed in 100% in saccinylcholine group and 88% of sevojlurane group. Hemodynamic responses in sevojlurane group were more stable than succinylcholine group. So, inhalation technique with sevojlurane may be an alternative for endotracheal intubation in adults regards to smooth induction, hemodynamic stability and no airway irritation