Introduction: Tracheal Intubation without the use of neuromuscular blocking drugs was used to assess the airway by laryngoscopy. We compared the effect of midazolam and lignocaine on intubating conditions along with propofol and
fentanyl for intubating without neuromuscular blockers.
Aim: To compare the intubating conditions and cardiovascular changes (post induction) between fentanyl, midazolam, propofol and fentanyl, lignocaine, propofol groups without using neuromuscular blocking agents.
Materials and Methods: It is a prospective double blind randomized controlled study. After getting the ethical committee approval and informed written consent hundred patients undergoing elective surgical procedure under general anaesthesia with endotracheal intubation were selected. Group (M) received propofol 2.5mg/kg, fentanyl 2µg/kg, midazolam 0.03mg/kg. Group (L) received propofol 2.5mg/kg, fentanyl 2µg/kg, lidocaine 1.5mg/. Laryngoscopy was done 40 s after propofol administration. The patient’s trachea was intubated with an appropriate size cuffed tracheal tube.
Results: There is no statistical significance in patient characteristics and mallampatti and Cormack–lehane grading between these two groups.The statistical significance less time for laryngoscopy duration and Intubation attempt was successful in all (100%) patients in the M group than in the L group 43 out of 50 patients (86%). Changes in Mean arterial pressure was less with midazolam group than lignocaine group.
Conclusion: We conclude that the propofol–fentanyl – midazolam combination is better compared to propofol– fentanyl– lignocaine combination in providing clinically acceptable conditions for intubation without significant cardiovascular changes without the use of neuromuscular blocking agents
Keywords: Midazolam; Lignocaine; Propofol; Layrngoscopy.Corresponding Author
: M. Karthik, Assisstant Professor, Department of Anesthesiology, Stanley Medical College and Hospital, Chennai, Tamil Nadu 600001, India.