Intubating Conditions with Varying Doses of Propofol Without Muscle Relaxants in Paediatric Patients

Abstract

Background: Propofol has been widely used in anaesthetic practice as an induction agent, with certain advantages over other agents such as thiopental and etomidate, including a rapid recovery and antiemetic action. These characteristics have made Propofol the agent of choice for short surgical procedures especially in outpatient surgery. The first stage of the elimination half-life of Propofol is lower in children thus ensuring rapid recovery after short surgical procedures. It can be used for intubation without muscle relaxant in children helping in avoiding side effects. Aim: To compare the frequency of acceptable intubating conditions with 3.0mg/kg and 3.5mg/kg doses of Propofol without muscle relaxant in paediatric patients undergoing elective surgery. Methods: This was a Randomized Controlled Trial conducted at Department of Anaesthesiology, Mayo Hospital Lahore. After informed consent from parents of the patients and IRB approval, 400 patients planned to undergo elective surgery were included in the study. Patients were randomly divided into 2 groups of 200 patients each using lottery method. Group I received Inj. Propofol 3.0mg/kg body weight while Group II received Inj. Propofol 3.5mg/kg body weight. Patients were intubated 90seconds after injecting Propofol. For study purpose, single successful intubation attempt was considered and acceptable intubating conditions were labelled (as per operational definition). Data entry and analysis was done by using SPSS 18 according to the approved analysis plan. Results: Mean age of patients in Group-I and in Group-II was 7.36±2.50 and 7.14±2.00. Mean weight of patients in Group-I and in Group-II was 28.51±7.04 and 29.47±5.35. In Group-I mean duration of laryngoscopy was 18.36±3.47 and in Group-II mean duration of laryngoscopy was 17.78±3.42 minutes. Acceptable intubation was achieved in 154(77%) patients in Group-I while in Group-II acceptable intubation was achieved in 186(93%) patients. (P value=0.000). Conclusion: According to the results of this study acceptable intubating conditions is higher with Group-II [3.5mg/kg: (93%)] as compared to that of Group-I [3.0 mg/kg :(77%)] without muscle relaxant in paediatric patients undergoing elective surgery. So in our clinical set up a dose of 3.5mg/kg propofol is effective for acceptable intubating condition in paediatric population without muscle relaxant.