Use of alfentanil with propofol for nasotracheal intubation without neuromuscular block.

We have investigated the effect of augmentation of propofol with alfentanil for nasotracheal intubation without neuromuscular block in 60 patients undergoing short elective maxillo-facial procedures as outpatients. After administration of glycopyrronium 5 micrograms kg-1 i.v., anaesthesia was induced with propofol 2.5 mg kg-1, or alfentanil 20 micrograms kg-1 and propofol 2.5 mg kg-1. The alfentanil group had improved jaw relaxation (P < 0.001) and vocal cord conditions (P < 0.005). Tracheal intubation was successful in 83% of patients receiving alfentanil, and in 73% of patients receiving propofol only. This difference was not significant. The cardiovascular response to intubation was attenuated in the alfentanil group.