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Evaluation of Endotracheal Intubation with and without Neuromuscular Blocking in Pediatric Anesthesia

Author: Iyad Abbas Salman*, Reem Abbas Naem**, Aras As.Sediq
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 3 Pages: 220-224
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Endotracheal intubation is an important step in airway control in pediatric age group, the drugs used for this purpose are ultra-short acting hypnotic agents plus neuromuscular blocking agents (NMBA). NMBA have many serious side effects.OBJECTIVE :To evaluate endotracheal intubation without using NMBA, and assess the intubation conditions and hemodynamic response to this method of intubation in pediatric age groupPATIENTS AND METHOD: This is a prospective randomized double blind study done in Rizgary teaching general hospital from 1/ October to 1/ December 2012 included 60 patients age 4-8 years,American society of anesthesiologist (ASA) I or II.Patients were allotted to one of these two groups randomly 30 patients per each group. Group (F): those patients that receive Fentanyl 4 μg/kg I.V +Propofol 3 mg/kg I.V. Group (S): those patients that receivePropofol 3 mg/kg +suxamethonium 1 mg/kg I.V. Intubation conditions and hemodynamic changes have been measured and compared between both groups.RESULTS:In group F acceptable intubation conditions were obtained in 27 (89%) patients.whileFair intubation conditions occurred in only 3 (11%) patients. In group S acceptable intubation conditionsoccurred in 30 (100%) of patients.In S group there was a significant rise in systolic arterial pressure(SAP) and heart rate (HR) in 0, 1, 3 minute after intubation (P<0.001).In F group there was significant decrease in SAP (P<0.001) in post induction reading. In F group there was non-significant decrease in HR in post intubation time 1, 3 minutes (P>0.05).CONCLUSION:Endotracheal intubation can be accomplished in pediatric age group using Fentanyl and Propofol without the need to use muscle relaxant with acceptable hemodynamic response.KEY WORDS: endotracheal intubation, fentanyl, Propofol, suxamethonium.

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