BACKGROUND: To facilitate tracheal intubation, either a neuromuscular blocking agent or a bolus dose of remifentanil can be administered. We hypothesised that rocuronium 0.6 mg kg-1 provided a larger proportion of excellent intubating conditions compared to remifentanil 2 µg kg-1 in patients above 80 years. METHODS: A total of 78 patients were randomised to either rocuronium 0.6 mg kg-1 or remifentanil 2 µg kg-1 . General anaesthesia was initiated with fentanyl and propofol. Two minutes after the administration of either rocuronium or remifentanil, tracheal intubating conditions were evaluated using the Fuchs-Buder scale by a blinded investigator, and our primary outcome was the proportion of patients presenting intubating conditions deemed as excellent. Further outcomes included the Intubating Difficulty Scale (IDS), hoarseness or sore throat 24 hours postoperatively, and intervention against hypotension. RESULTS: No difference in the occurrence of excellent intubating conditions was found comparing the rocuronium group with the remifentanil group; 10 (28%) vs. 15 (39%) (P=0.29), respectively, relative risk =0.72. Interventions against hypotension were used in 24 (67%) vs. 28 (74%) (P=0.51), respectively. Hoarseness and sore throat 24 hours postoperatively were found in 37% vs 35% P=0.86, and 14% vs 5% P=0.20, respectively. The IDS score was 2 vs 2 P=0.48 CONCLUSION: No difference in intubating conditions was found 2 minutes after the administration of either rocuronium 0.6 mg kg-1 or remifentanil 2 µg kg-1 in patients aged above 80 years. Intubation conditions were less than optimal in a large proportion of this patient population. This article is protected by copyright. All rights reserved.
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BACKGROUND: To facilitate tracheal intubation, either a neuromuscular blocking agent or a bolus dose of remifentanil can be administered. We hypothesised that rocuronium 0.6 mg kg-1 provided a larger proportion of excellent intubating conditions compared to remifentanil 2 µg kg-1 in patients above 80 years. METHODS: A total of 78 patients were randomised to either rocuronium 0.6 mg kg-1 or remifentanil 2 µg kg-1 . General anaesthesia was initiated with fentanyl and propofol. Two minutes after the administration of either rocuronium or remifentanil, tracheal intubating conditions were evaluated using the Fuchs-Buder scale by a blinded investigator, and our primary outcome was the proportion of patients presenting intubating conditions deemed as excellent. Further outcomes included the Intubating Difficulty Scale (IDS), hoarseness or sore throat 24 hours postoperatively, and intervention against hypotension. RESULTS: No difference in the occurrence of excellent intubating conditions was found comparing the rocuronium group with the remifentanil group; 10 (28%) vs. 15 (39%) (P=0.29), respectively, relative risk =0.72. Interventions against hypotension were used in 24 (67%) vs. 28 (74%) (P=0.51), respectively. Hoarseness and sore throat 24 hours postoperatively were found in 37% vs 35% P=0.86, and 14% vs 5% P=0.20, respectively. The IDS score was 2 vs 2 P=0.48 CONCLUSION: No difference in intubating conditions was found 2 minutes after the administration of either rocuronium 0.6 mg kg-1 or remifentanil 2 µg kg-1 in patients aged above 80 years. Intubation conditions were less than optimal in a large proportion of this patient population. This article is protected by copyright. All rights reserved.